Factors and Forces Affecting Ehr System Adoption: Report of a 2004 Acmi Discussion

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8 Position Paper j ASH, BATES, EHR System Adoption Factors and Forces Affecting EHR System Adoption: Report of a 2004 ACMI Discussion JOAN S. ASH, PHD, DAVID W. BATES, MD, MSC Abstract After the first session of the American College of Medical Informatics 2004 retreat, during which the history of electronic health records was reviewed, the second session served as a forum for discussion about the state of the art of EHR adoption. Adoption and diffusion rates for both inpatient and outpatient EHRs are low for a myriad of reasons ranging from personal physician concerns about workflow to broad environmental issues. Initial recommendations for addressing these issues include providing communication and education to both providers and…show more content…
Adoption of EHRs, with or without CPOE, is equally low in the outpatient setting, although a comprehensive national survey with a high response rate is not available. The rate seems to be somewhere between 5% and 39% (D. J. Brailer, personal communication, 2003) with a predicted increase of 15% to 30% per year over the current level of adoption. It should be noted that most data in this study were from industry sources, which may have vested interests in this prediction, and different definitions of the EHR were used. Data from HIMSS concerning the adoption gap indicate differences in adoption among different kinds of practices: the rates cited range from 10% for pediatric practices to more than 40% for internal medicine practices.6 Furthermore, small practices are much less likely to adopt than larger ones. One large difference between inpatient EHRs with CPOE and ambulatory EHRs is that there is considerable international experience with ambulatory EHRs from which those in the United States can learn a significant amount. Countries like Sweden, the Netherlands, and Australia have more than half of their primary care physicians using the EHR. In Sweden, 90% of primary care physicians use it, in Denmark Journal of the American Medical Informatics Association Volume

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