Variation in electronic health record adoption and readiness for meaningful use: 2008-2011.
BACKGROUND
Federal initiatives are underway that provide physicians with financial incentives for meaningful use (MU) of electronic health records (EHRs) and assistance to purchase and implement EHRs.


OBJECTIVE
We sought to examine readiness and interest in MU among primary care physicians and specialists, and identify factors that may affect their readiness to obtain MU incentives.


METHODS
We analyzed 4 years of data (2008-2011) from the National Ambulatory Medical Care Survey (NAMCS) Electronic Medical Record (EMR) Supplement, an annual cross-sectional nationally representative survey of non-federally employed office-based physicians.


METHODS
Survey-weighted EHR adoption rates, potential to meet selected MU criteria, and self-reported intention to apply for MU incentives. We also examined the association between physician and practice characteristics and readiness for MU.


RESULTS
The overall sample consisted of 10,889 respondents, with weighted response rates of 62 % (2008); 74 % (2009); 66 % (2010); and 61 % (2011). Primary care physicians' adoption of EHRs with the potential to meet MU nearly doubled from 2009 to 2011 (18 % to 38 %, p<0.01), and was significantly higher than specialists (19 %) in 2011 (p<0.01). In 2011, half of physicians (52 %) expressed their intention to apply for MU incentives; this did not vary by specialty. Multivariate analyses report that EHR adoption was significantly higher in both 2010 and 2011 compared to 2009, and primary care physicians and physicians working in larger or multi-specialty practices or for HMOs were more likely to adopt EHRs with the potential to meet MU.


CONCLUSIONS
Physician EHR adoption rates increased in advance of MU incentive payments. Although interest in MU incentives did not vary by specialty, primary care physicians had significantly higher rates of adopting EHRs with the potential to meet MU. Addressing barriers to EHR adoption, which may vary by specialty, will be important to enhancing coordination of care.
Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services, Washington, DC, USA. Vaishali.patel@hhs.gov
Vaishali
V
Patel
Eric
E
Jamoom
Chun-Ju
CJ
Hsiao
Michael F
MF
Furukawa
Melinda
M
Buntin
D000328:Adult; D001292:Attitude to Computers; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000639:trends*; D005260:Female; D019538:Health Care Surveys / Q000639:trends*; D006801:Humans; D008297:Male; D062527:Meaningful Use / Q000639:trends*; D008875:Middle Aged; D010820:Physicians / Q000523:psychology / Q000639:trends*; D057566:Self Report