It seems to be difficult—perhaps more difficult than it should be—to get an accurate estimate of how many physician offices are actually using electronic health record systems. The go-to survey during the last year or so, when the HITECH Act and healthcare reform were being drafted, has been a Harvard Medical School study from 2008, which reported that only 17% of office-based physicians were using EHRs.
But a recent National Ambulatory Care Survey, conducted by the National Center for Health Statistics, suggests that number was much higher in 2008—above 38%. Preliminary data for 2009 puts the overall adoption rate at 44%.
The discrepancy between the two estimates is pretty startling. The NACS reports that most of the decade's growth happened in 2007-2008, when usage of EHRs jumped 19%. Perhaps the data in the Harvard study lagged a bit and just missed a major shift in adoption.
As the industry is learning from the process of developing meaningful use standards for the HITECH Act, so much depends on how you measure and define an EHR system. Adoption rates will vary significantly depending on whether we're talking about a full-fledged system or a bare-bones electronic health record. Even in the NACS survey, only 4.4% of doctors reported having a "fully-functional" system.
So the overall adoption rate is somewhere between 4.4% and 44%, depending on how optimistic you want to be and which survey you use.
But the real takeaway from the latest survey isn't just the absolute adoption rate. It's the progress that has been made. In the last decade, using the NACS estimates, physician adoption has climbed from 19% to 44%. That's pretty impressive and contradicts a lot of the conventional wisdom about physicians' struggles.
There have been challenges. Electronic health record systems are expensive. Reimbursement has been stagnant or falling. Installing the systems can be disruptive, and some physicians still aren't convinced that they are worth it.
But despite all of that, physician practices are finding ways to move forward and prepare for the future of healthcare, and they are now in a position to receive $44,000 for their efforts.
Suddenly the HITECH Act's ambitious goal of near-widespread adoption by 2014 seems more achievable, even if the industry is still likely to fall short. There is certainly less ground to cover.
Many challenges remain, particularly for small and rural physician practices. But I'm convinced, particularly after these latest numbers, that physicians can overcome them. Roughly 44% of physicians have already started paving the way.
Even for those pessimistic about EHR adoption, the glass is nearly half full.