LOS ANGELES — Cost is the most frequently cited barrier to adoption of electronic health records, according to survey findings presented as a poster at the annual meeting of the Society of General Internal Medicine.
Although electronic health records (EHRs) appear to increase the efficiency and quality of medical care, few published studies have assessed how many ambulatory care practices in the United States currently use EHRs.
Dr. Steven Simon and his team at Harvard Medical School, Boston, conducted a survey of physicians practicing in Massachusetts in 2005. The findings revealed barriers to making a smooth transition from paper-based record systems to EHRs.
Overall, 23% of physicians who responded to the Harvard survey used EHRs in their practices—most of them (58%) for at least the previous 3 years. A larger proportion of multispecialty practices (35%) than primary care practices (25%) were using EHRs. Larger practices (seven or more physicians) were more likely to adopt EHRs than were solo practices (57% vs. 15%). Hospital-based practices or those with computerized office systems were also more likely to use EHRs.
Barriers to adopting EHRs identified by survey respondents included start-up costs (75%), maintenance costs (72%), loss of productivity while learning (73%), lack of computer skills (57%), skepticism about benefits (54%), and privacy or security concerns (48%). Physicians who listed start-up costs and loss of productivity as reasons not to adopt EHRs were significantly less likely to use EHRs in their practices.
Although the survey was conducted in a single state, it did target practices that varied widely in terms of number of physicians, specialties, hospital associations, and urban vs. rural location.