UCLA

Despite high levels of investment, expectation, and effort to push forward the adoption of Electronic Health Records (EHR) nationally, challenges for physicians in doing so and slow rates of adoption persist. However, the great promise of EHR—improved quality and cost performance of health care—depends on physician use of EHR systems. This study aims to provide findings and recommendations to inform research and policy regarding EHR adoption by physicians for use in their practices.

The data source for this study is the Center for Studying Health System Change (HCS) and Community Tracking Study (CTS) Physician Survey, Round 3 (2000–2001) and Round 4 (2004–2005). The theoretical anchor is Rodgers’ Diffusion of Technology Theory (Rogers, 1962, 1981).

The methods employed in this study include descriptive statistics, Cronbach’s Alpha, sub-scale tests, Exploratory Factor analysis, and Guttmann scaling, regression, difference-in-differences analysis, cross-sectional analyses and others statistical methods.

The findings are as summarized: 1) Though small and medium/large practices increased their use of EHRs over the period, small practices increased at a lower rate, thus gap in EHR adoption rates between small and medium/large practices increased over the study period. 2) Small and medium/large practices are de-adopting EHR functionality over time, a finding not noted before. However, this de-adoption is muted by the overall net increase in adoption scores over time. 3) Characteristics associated with lower adoption include: female, non-white, in oldest groups, and small practices. Managed care as a source of revenue for physician practices was associated with increased EHR adoption.