A tool for tracking EHR adoption rates

[ Fall 2008 ]

Tracking the progress of adoption rates requires reliable record-keeping

Tracking the progress of anything, including health IT adoption, requires reliable record-keeping. The July 3 New England Journal of Medicine survey report, funded by the Office of the National Coordinator of Health Information Technology (ONC), set a baseline so that future changes can be measured accurately.

“If you want to get somewhere, first you’ve got to know where you are,” says a co-author, HSPH’s Ashish Jha. “What this study does is establish the baseline of, ‘Here’s where things are in 2008.’ The good news is, it tells us exactly where we are; but the bad news is, we’re a lot further behind than we’d like to be.”

Previous surveys had pegged EHR adoption rates at anywhere from 9 percent to 25 percent of doctors and had relied on various definitions for technology terms. “One of the reasons ONC funded this was for us to develop standardized methods, so that when people do these surveys in the future, the data are comparable,” explains first author Catherine DesRoches, of the Institute for Health Policy.

To develop questions, the researchers consulted a panel of 20 experts in survey research, health IT, and health care management and policy, plus representatives of hospitals and physician groups. For the survey’s purposes, a fully functional EHR system was defined as having the capability to:

  • Record patients’ clinical and demographic data;
  • View and manage results of laboratory tests and imaging;
  • Manage order entry, including electronic prescription and the ability to order tests and imaging;
  • Support clinical decisions, including warnings about drug interactions or contraindications.

A basic EHR system, for the survey’s purposes, is one that allows just some of the first three of those functionalities.