Physicians and electronic health records: a statewide survey

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This is a review of Simon SR et al's 2007 article, Physicians and electronic health records: a statewide survey. [1]


In this article the authors describe a survey of 1884 Massachusetts physicians and report the findings of the survey. The survey was about electronic health record (EHR) functions. This statewide survey was designed to assess :

  1. characteristics of EHR use
  2. predictors of EHR adoption and use
  3. effect of computers on health care
  4. relationship between EHR adoption and use and physician satisfaction

The survey

An 8-page survey was mailed to a random sample of 1884 physicians in 2005. Each of the physicians represented one of 6174 unique practices in the state. The survey asked the subjects to indicate their practice used an electronic health record system. If they answered “yes”, they were asked to indicate whether or not the 10 functions were available and the degree they use each of those functions. Other questions asked in the survey include how they perceive computers and 8 dimensions of clinical practice, characteristics of their practice, such as number of physicians, number of visits, number of years since they graduate from medical school, number of years of practice. The survey was mailed to each subject via express mail with a $20 honorarium.

The results

Based on the 1345 responses that returned, the investigators found that :

  1. Massachusetts has 28.8% EHR adoption rate. The most commonly reported functions were the ability to view laboratory reports (84.8%) and to document visits electronically (84.0%). The least available functions were laboratory test order entry (46.8%), and prescription transmittal to a pharmacy electronically (44.7%).
  2. Fewer than 75% of the respondents who had systems with the 10 functions assessed actually use these functions most or all of the time. The most used function (73.6%) was viewing radiology test results, and the least used function (32.1%) was clinical decision support.
  3. Comparing the EHR adopter and non-adopter groups, the survey revealed that the adopter group had fewer years since medical school completion, had been in their practice fewer years, were less likely to have ownership, and were more likely to use the Internet daily.
  4. The adopter group also reported more positive views of the effect of computers on health care than the non-adopter group.


This study found that the state of Massachusetts had 28.8% EHR adoption rate as compared to the national EHR adoption rate of 25% from a recent report.[1] Another study conducted in 2005 by the Medical Group Management Association (MGMA) Center for Research and the University of Minnesota School of Public Health reported a national rate of 14.1%.[2]

The findings of this statewide study raise an important issue concerning the gap between availability and use for decision support function. If this finding holds true for the rest of the country, then it would be an important issue for EHR implementation nationwide.


  1. Simon SR, Kaushal R, Cleary PD, Jenter CA, Volk LA, Orav EJ, Burdick E, Poon EG, Bates DW. Physicians and electronic health records: a statewide survey. Arch Intern Med. 2007 Mar 12;167(5):507-12.
  1. Burt CW, Hing E. Woodwell D. Electronic medical record use b office-based physicians: United States, 2005.
  2. Gans D, Kralewski J, Hammons T, Dowd B. Medical groups' adoption of electronic health records and information systems. Health Aff (Millwood). 2005 Sep-Oct;24(5):1323-33.