title: Promoting electronic health record adoption among small independent primary care practices.
abstract: OBJECTIVE
  To describe the benefits and limitations of incentive arrangements used to engage small primary care practices to adopt electronic health records (EHRs).
  
  
  METHODS
  Retrospective review of program outreach efforts and EHR enrollment rates.
  
  
  METHODS
  Comparison of benefits and limitations of various promotional strategies in addition to a city subsidy. Measures of enrollment progress include the mean number of outreach attempts, the mean number of days from first attempt to enrollment, and the enrollment yield. Selected practice demographics were collected for comparison purposes.
  
  
  RESULTS
  Of 890 providers representing 217 practices who were eligible for the city subsidy, 37.7% enrolled, with a mean of 96.6 days from first attempt to enrollment and a mean of 10 outreach attempts. The offer for full payment of technical assistance fees and hardware yielded an additional 100 providers representing 43 practices, a 14.1% enrollment rate. This group also had the highest mean number of days from first attempt to enrollment (236.0 days) and the highest mean number of outreach attempts (22 attempts). The offer for a partial rebate had the lowest yield (a 6.2% enrollment rate), a mean of 169.3 days from first attempt to enrollment, and a mean number of 19 outreach attempts.
  
  
  CONCLUSIONS
  Because of diverse needs and levels of awareness in the EHR adoption process, a flexible milestone-based process is needed to engage primary care providers. In particular, community influence and additional funding were necessary for increasing enrollment among providers in medically underserved neighborhoods. These providers also required persistent and numerous follow-up attempts. Because billions of dollars in federal aid are being offered, effective local recruitment strategies are needed to facilitate provider engagement to increase EHR adoption rates.
authors: California Health Information Partnership and Services Organization, Oakland, CA, USA.
authors: Reena
authors: R
authors: Samantaray
authors: Victoria O
authors: VO
authors: Njoku
authors: Julian W M
authors: JW
authors: Brunner
authors: Veena
authors: V
authors: Raghavan
authors: Mat L
authors: ML
authors: Kendall
authors: Sarah C
authors: SC
authors: Shih
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D009042:Motivation; D009518:New York; D011216:Practice Management, Medical / Q000458:organization & administration* / Q000639:trends; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies