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Electronic Medical Records: Much Talk, Not Much Action

A survey indicates that less than a quarter of U.S. physicians have adopted electronic systems.

Moving medical record-keeping from paper to computer is seen as one of the next big things in clinical practice, but a survey demonstrated that few doctors have made the switch. Surveys were mailed to a random national sample of U.S. physicians who were listed in the American Medical Association database as providing direct patient care.

Of 2607 physicians who submitted complete responses, only 330 (13%) used any sort of basic electronic medical record system in outpatient practice, and only 117 (4%) used a system sophisticated enough to flag problematic clinical decisions and to order all tests. An additional 16% reported that their practices had purchased but not yet implemented electronic records systems.

Physicians who used electronic systems were younger and worked in larger groups than did nonusers. A great majority reported satisfaction with the ease and reliability of electronic records. Among nonusers of electronic records, the most commonly cited obstacles to adoption were cost, not finding a suitable system, concern about return on investment, and concern that the system would become obsolete.

Comment: With a 62% response rate, this survey might have overestimated use rates of electronic medical systems. The results show how cautiously most U.S. physicians are circling the decision to adopt electronic systems. Furthermore, the authors argue that enthusiasm for electronic records among those who do use them should be extrapolated with caution: Basic differences in practice habits among those with and without electronic record-keeping mean that they might not, in fact, be suitable for all.

— Abigail Zuger, MD

Published in Journal Watch General Medicine July 17, 2008

Citation(s):

DesRoches CM et al. Electronic health records in ambulatory care — A national survey of physicians. N Engl J Med 2008 Jul 3; 359:50.

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