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Smaller physician office practices are slower to adopt use of electronic health records

Electronic health records (EHRs) can improve the safety and quality of health care. In Massachusetts, as in other parts of the United States, nearly half of physicians in office practices are now using EHRs. However, most small office practices still do not have EHRs, according to a new study.

Researchers found that fewer than one in four Massachusetts practices had adopted EHRs. Adoption rates were lower in smaller practices, those not affiliated with hospitals, and those that did not teach medical students or residents.

About 80 percent of doctors whose practices had not yet adopted EHRs cited financial factors, including start-up financial costs, ongoing financial costs, and loss of productivity, as barriers to technology adoption. The majority of physicians also pointed to technical factors as important barriers. These included lack of computer skills, lack of technical support, lack of uniform standards, and technical limitations of systems. Finally, 55 percent of physicians voiced concerns about privacy or security as a barrier to adopting use of EHRs in their practices.

These findings suggest that programs to increase the adoption of EHRs should focus on the practice level, where decisions to adopt EHRs are made. These programs should also help physicians modify their workflow to get the most out of EHRs and explicitly acknowledge and address privacy concerns, suggest the researchers. The study was supported by the Agency for Healthcare Research and Quality (HS15397).

See "Correlates of electronic health record adoption in office practices: A statewide survey," by Steven R. Simon, M.D., M.P.H., Rainu Kaushal, M.D., M.P.H., Paul D. Cleary, Ph.D., and others, in the January 2007 Journal of the American Medical Informatics Association 14(1), pp. 110-117.

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