That fraction falls to 20 percent if the definition of EHR is restricted to a system that stores medical and demographic information in a relational database and is accessed though a computer terminal.
Jeff Flick, regional administrator of CMS (Centers for Medicare and Medicaid Services), said that in his experience, the fraction of physicians using EHRs is even lower. Flick helps run a program, DOQ-IT, for physicians working to implement IT. He attributed the difference to the definition of EHR, saying MGMAs definition was "on the loose side," and that EHR systems should also have more sophisticated capabilities, such as decision support tools.
Well-implemented EHRs are expected to make patient information readily available to nurses and doctors and align this information with current care guidelines. This should prevent medical errors, personalize treatment and reduce unnecessary or duplicate procedures. EHRs can also ease communication between health care providers and between providers and payers.
About 40 percent of survey respondents said they planned to adopt EHRs within the next two years. Flick said this was encouraging, but not surprising, particularly given the emphasis health IT has received from high-level government officials, including President Bush.
"In 30 years of medical practice, Ive never seen such enthusiasm for electronic solutions," MGMA President and Chief Executive William Jessee, said in a Webcast for group members. However, he said implementing systems was a financial burden to physician offices already facing higher expenses and, soon, lower Medicare reimbursement rates.
"The question has been, who will pay [for EHR systems]? And the answer so far has been nobody," he said.
Speaking at the conference where the survey results were announced, health IT czar David Brailer promised to build a better business case for EHRs but emphasized that the help was much more likely to come in the form of tax breaks than direct federal grants.
A variety of groups representing vendors and health care providers have jointly formed the Certification Commission for Healthcare Information Technology, which aims to make the marketplace less risky and confusing for physicians by establishing criteria that health care IT vendors must meet to win the Commissions seal of approval.
Flick said that as common standards and definitions were accepted, EHR systems could be trusted to reliably improve patient care and track whether physicians were following current practice guidelines. At that point, health care payers would adopt more pay-for-performances programs, rewarding physicians who adopt information technology.
Other government and non-government groups have sprung up to help physician practices implement EHR. For example, DOQ-IT provides free, intense consulting services for small and medium practices working to implement health IT.
The results show that doctors groups are bringing EHR online in pieces. Of those surveyed, 15 percent have a system for all locations and all doctors; 15 percent have a system thats partially implemented or at only a few locations; 8 percent can combine physician notes with paper charts and 3 percent just store scanned documents.
Asked which pieces should be put into place first, Flick responded that the answer depended on the physician practice.
These results are based on the first 1,061 e-mail responses to MGMAs survey, all from members of the association, which is open to professionals managing groups of three or more physicians. Results from a random sampling of 16,000 groups, including 5,000 non-member practices, should be available in March.