Dates of the Project: January 2006 through July 2013

Field of Work: Measuring adoption and use of electronic health record systems among physicians and hospitals

Problem Synopsis: When widespread adoption of electronic health record systems became a federal policy priority in 2004, no one knew how many physicians and hospitals had already installed the systems and what those systems included. Without reliable information, policy-makers could not determine where and at what level resources should be applied.

Synopsis of the Work: Researchers tracked electronic health record system adoption rates beginning in 2007 and analyzed differences in adoption rates by the type of physician practice or hospital.

They produced five reports and about a dozen journal articles. These analyses used data collected through surveys developed and fielded in work supported by the federal Office of the National Coordinator of Health Information Technology. The same team of researchers (from Massachusetts General Hospital, Harvard School of Public Health, Mathematica Policy Research, and—supported by the Office of the National Coordinator—George Washington University School of Public Health and Health Services) worked on both projects.

Key Findings:

• The percentage of physicians with at least a basic electronic health record system grew from 17 percent in late 2007/2008 to 35 percent in 2011. The percentage of hospitals with at least a basic system grew from 9.1 percent in late 2007/early 2008 to 26.6 percent in 2011.
• Younger physicians, primary-care practices, and large practices adopted electronic health record systems at a faster rate than older physicians, specialists, and those in small practices.
• While quality of care at hospitals caring for a large number of poor patients was lower than in other hospitals, that difference disappeared for such hospitals with electronic health record systems.
• Large hospitals, teaching hospitals, and those located in urban areas adopted electronic health-record systems at faster rates than small, nonteaching, and rural hospitals.
• Due to business, technical, and cultural hurdles, little exchange of health information among physicians or hospitals is taking place as of 2012.