Sunday, June 22, 2008

Studies on EHRs Available

The Creighton University Health Services Research Program along with the South Dakota State Medical Association conducted a survey to learn what factors are influencing HIT adoption in the state. The report “Status of Health Information Technology in South Dakota: Focus on Electronic Health Records in Physician Offices” released June 2008, summarizes the state of EHR adoption of physician practices in South Dakota as of November 2007.

The results in the report will be used to design education practices to help in EHR adoption for health professionals and policy makers in the state. Patterns of adoption may also help policy makers further advance educational efforts and resource decisions involving health information exchange and infrastructure development. The findings may also help health professionals in their decision-making processes on the adoption of HIT.

The cross sectional survey was distributed to South Dakota physicians in October and November 2007 using the state licensure database as the primary record source to identify physicians. Surveys were distributed to 2,217 South Dakota licensed physicians who had a mailing address in the state or in an adjacent state. Three hundred forty three physicians maintaining ambulatory care practices in the state completed the survey.

The physicians using HIT tended to be located in larger populations across the state. Those physicians in the planning stage of EHR implementation represented the largest group of reporting physicians in the state and were mainly located in the eastern half of the state.

Some of the highlights are:

  • Nearly all physicians would like to use desktop computers laptop/notebook computers, tablet PCs and PDAs in their future practice.
  • In today’s environment nearly all physicians are using desktop computers while use of other technologies is not as prevalent
  • EHR users represented 29% of physicians in office practices, planners represented 55% of physicians in office practices, and non-planners represented 16% of physicians in office practices
  • Administrative computer applications are used equally by physician practices regardless of the stage of EHR adoption
  • Most prescriptions are still generated using a handwritten prescription pad for all stages of EHR adoptions. EHR users tend to use laptop or desktop computers more than nonusers to generate prescriptions. However, traditional methods of prescription delivery to pharmacies still predominates
  • The main barriers to EHR adoption are financial and lack of interoperability

The survey found that EHR users directly observing or experiencing patient safety incidents was higher for EHR users as compared to nonusers. This was a surprise and the explanation may be that there are substantial problems in information management and exchange related to the interoperability requirements of an EHR. Additional research is needed in this area.

According to a new study “Electronic Health Record Adoption in the Ambulatory Setting: Findings from a National Survey of Physicians” made available on-line appeared in the New England Journal of Medicine. The study shows that only 4% of physicians from a survey of 2,758 physicians have a fully functional EHR system and only 13% have a basic system.

The study was conducted between September 2007 and March 2008 by lead study author Catherine DesRoches, David Blumenthal, MD., and a team at MGH, Weill Cornell Medical College, and the George Washington University School of Public Health and Health Services.

The survey found that cost and complexity are key barriers. Two thirds of physicians without EHRs cited affordability as the reason they don’t have an EHR. Other reasons included finding the right EHR, concern about return on investment, and that the system will become obsolete. One in five physicians expressed reservations about the ease of use and reliability of their systems.

Another study “Health Information Technology in the United States: Where We Stand in 2008”, funded by RWJF and co-authored by the Institute for Health Policy at MGH and George Washington University will be available in July.

To see the South Dakota report, go to For copies of the study “Electronic Health Record Adoption in the Ambulatory Setting, Findings from a National Survey of Physicians”, contact Isha Mehmood at or call 301-652-1558.