July 30, 2012
By Ami Patel
In an era where technology has seemingly permeated the majority of our lifestyle, the health system continues to struggle with the application and utilization of information technology to create a more efficient and accessible system. The implementation of an Electronic Health Record (EHR) seems like a no-brainer solution to organize the health system, especially in a world where technology has replaced traditional forms of organization and communication with spreadsheets, emails and apps. Then why is the American health system still struggling to adopt a widespread EHR? The answer lies in a fragmented system characterized by a continuum of provider care ranging from traditional, small physician practices to larger, high-tech health centers.
It is understood people have varying thresholds for adopting innovations, and the healthcare system is a prime example of this theory. In 2002, one in five office based physicians had EHR systems, and by 2011 the adoption rate tripled amongst physicians. Providers saw the value in EHRs for organizing their patient’s medical history for more coordinated care, and also in providing a backup system during emergency scenarios where paper records could easily be lost. The challenge to creating a uniform adoption of EHR’s is in identifying the late adopters and targeting those physicians who are not comfortable with deviating from traditional charts and paper records. A Health Affairs article explored various physician characteristics in relation to adopting an EHR. The trends that surfaced revealed non-primary care specialist, physicians fifty-five and older, and physicians in small (1-2 providers) practices were slower to adopt EHR’s. These slower rates can be attributed to federal polices that narrow their aim to increase technology use amongst primary care providers. Initiatives by the Office of the National Coordinator for Health Information Technology have provided centers of support for the training and use of an EHR for primary care providers, but there are no comparable programs aimed at non-primary care physicians who consistently indicate a lower rate of adoption.
There is anticipation of a younger generation of providers who will increase EMR adoption, but the shift will be gradual. Nationwide initiatives for spreading the EHR system need to expand to non-primary care physicians and small practices in order to narrow the gap in adoption and utilization rates. Despite the progress made in Health IT, the rhetoric of incorporating technology into healthcare should diffuse into all sectors of medical practice in order to achieve uniform use.
Ami Patel is a second year MPH student at the George Washington University with a concentration in Health Policy. She graduated from the University of Georgia with a degree in Health Promotion and Behavior and currently as works as a research assistant for the Center for Healthcare Quality at the George Washington University.