Stream Glen R
Clinical Information Services, Rockwood Clinic, 14408 East Sprague Avenue, Spokane, Washington 99216, USA.
Inform Prim Care. 2009;17(3):145-52. doi: 10.14236/jhi.v17i3.729.
Electronic health record (EHR) adoption is encouraged by health plans, government agencies, and both the American Academy of Family Physicians and the Washington Academy of Family Physicians (WAFP), but rates of EHR adoption by family physicians in Washington were previously unknown. This study measured current rates of EHR adoption by family physicians in Washington State, as well as perceived barriers to adoption and what physicians identify as possible means to overcome those barriers.
A survey of medical practices in Washington State was performed. One physician per practice was selected to respond on behalf of their practice for all practices where family physicians work and for which contact information was available in the databases of the Washington State Medical Association (WSMA) and WAFP. The survey was distributed either electronically or in print form depending on availability of an email address.
Rates of EHR adoption, plans for adoption for those not yet using EHRs, perceived barriers to EHR adoption and perceived means to overcome those barriers.
Response rate was 43.8%. EHR adoption by this group is relatively high at 57.9% and did not vary by practice location. Although solo practices had a relatively high rate of adoption (43.5%), EHR adoption remains strongly associated with practice size. Identified barriers to implementation are primarily financial, as are the means to overcome those barriers. If current trends continue, adoption will plateau at approximately 68% in the next four years.
Adoption rate appears to have peaked in this group given current constraints and barriers. Increased outreach efforts and assistance programs will be necessary to achieve EHR adoption in the remaining practices, particularly solo and small group practices.
健康计划、政府机构以及美国家庭医师学会和华盛顿家庭医师学会（WAFP）均鼓励采用电子健康记录（EHR），但此前华盛顿州家庭医师采用EHR的比例尚不清楚。本研究测量了华盛顿州家庭医师目前采用EHR的比例，以及采用过程中感知到的障碍和医师认为可能克服这些障碍的方法。
对华盛顿州的医疗实践进行了一项调查。在华盛顿州医学协会（WSMA）和WAFP数据库中可获取联系信息的所有家庭医师工作的医疗机构中，每家机构选择一名医师代表其机构进行答复。根据电子邮件地址的可用性，调查以电子方式或纸质形式分发。
EHR采用率、尚未使用EHR者的采用计划、EHR采用过程中感知到的障碍以及克服这些障碍的感知方法。
回复率为43.8%。该群体的EHR采用率相对较高，为57.9%，且不因医疗机构所在地而有所不同。虽然个体诊所的采用率相对较高（43.5%），但EHR采用率仍与诊所规模密切相关。确定的实施障碍主要是财务方面的，克服这些障碍的方法也是如此。如果当前趋势持续下去，未来四年采用率将稳定在约68%。
鉴于当前的限制和障碍，该群体的采用率似乎已达到峰值。需要加大推广力度并实施援助计划，以促使其余医疗机构采用EHR，尤其是个体诊所和小型诊所。
