EMRs Growing, Slowly

We're always trying to gauge the adoption of IT in healthcare, and the Center for Disease Control (CDC) recently put forth some numbers that prove what we already knew - adoption is still limited, although growing.

We're all pretty tired of hearing how "behind" healthcare is in deploying IT, but overall, researchers re-confirmed (in surveys conducted from 2001-2003) that the healthcare industry is behind other industries in terms of information technology adoption. The high point of the study released in mid-March comes in automated billing systems, which approximately three-quarters (73 percent) of physicians have adopted. But in clinical practice, less than one in five physicians is using electronic medical records.

The numbers stack up like this - about 31 percent of hospital emergency departments, 29 percent of outpatient departments and 17 percent of physician offices are using EMRs today. A 2002 HIMSS survey that included government-owned practices estimated that number at about 29 percent.

With an eye toward reducing medical errors, the survey found that automated drug dispensing systems are gaining ground - with about 40 percent of hospital EDs using them vs. 18 percent of outpatient departments. Large, high-volume EDs (25,000 patients per year) in metropolitan areas were the most likely to use automated drug dispensing. The report also found that only 8 percent of physicians, or one in 12, are using computerized physician order entry systems (CPOE) for ordering drugs and diagnostic tests. The highest infiltration was among physicians affiliated with a medical school. And age was a factor, too: physicians under 50 are twice as likely as physicians over 50 to use CPOE.
   
In terms of expenditures, the survey indicates that in 2001, U.S. providers spent $20 billion on IT, but less than a third or $6.5 billion, was spent for hospital clinical systems.

Time and money, we never have enough of it. And both are to blame in the slow adoption of EMRs due to the expenditure in time and human resources necessary to shift a practice from paper to electronic records. The Leapfrog Group estimates a 200-bed hospital will spend between $1 million and $7 million to implement EMR. The lack of uniform national standards for data entry and security is also holding things back.

To one-better next year's results, the survey is drilling down on selected attributes of the systems employed, in addition to overall penetration. And for an online resource on evaluating EHR vendors and public opinion on EMRs and privacy, see page www.pandab.org and www.centerforhit.org/x983.xml.

"Use of Computerized Clinical Support Systems in Medical Settings: United States, 2001-2003" is available at www.cdc.gov/nchs (and look under "What's New.")