Hsiao Chun-Ju, Hing Esther, Ashman Jill
Agency for Healthcare Research and Quality.
National Center for Health Statistics.
Natl Health Stat Report. 2014 May 20(75):1-18.
This report presents trends in the adoption of electronic health records (EHRs) by office-based physicians during 2007-2012. Rates of adoption are compared by selected physician and practice characteristics.
The National Ambulatory Medical Care Survey (NAMCS) is based on a national probability sample of nonfederal office-based physicians who see patients in an office setting. Prior to 2008, data on physician characteristics were collected through in-person interviews with physicians. To increase the sample for analyzing physician adoption of EHR systems, starting in 2008, NAMCS physician interview data were supplemented with data from an EHR mail survey. This report presents estimates from the 2007 in-person interviews, combined 2008-2010 data from both the in-person interviews and the EHR mail surveys, and 2011-2012 data from the EHR mail surveys. Sample data were weighted to produce national estimates of office-based physician characteristics and their practices.
In 2012, 71.8% of office-based physicians reported using any type of EHR system, up from 34.8% in 2007. In 2012, 39.6% of physicians had an EHR system with features meeting the criteria of a basic system, up from 11.8% in 2007; 23.5% of office-based physicians had an EHR system with features meeting the criteria of a fully functional system in 2012, up from 3.8% in 2007. In 2007, a wide gap existed in use of any type of EHR system between physicians in practices with 11 or more physicians (74.3%) compared with physicians in smaller practices (20.6% among solo practitioners); the gap, however, narrowed during 2007-2012. In 2007, no significant gap was observed in adoption of a fully functional system between primary care (4.7%) and nonprimary care physicians (2.8%); the gap, however, widened over time (27.9% compared with 19.4% in 2012). The difference in adoption of a fully functional system between physicians in practices with 11 or more physicians compared with solo practitioners was 10.4 percentage points in 2007; the gap widened to 30.6 percentage points in 2012.
本报告呈现了2007 - 2012年期间门诊医生采用电子健康记录（EHR）的趋势。通过选定的医生和执业特征对采用率进行比较。
国家门诊医疗调查（NAMCS）基于对在门诊环境中看诊患者的非联邦门诊医生的全国概率抽样。2008年之前，通过对医生的面对面访谈收集医生特征数据。为增加用于分析医生采用EHR系统情况的样本量，从2008年开始，NAMCS医生访谈数据补充了EHR邮件调查的数据。本报告呈现了2007年面对面访谈的估计数据、2008 - 2010年面对面访谈和EHR邮件调查的合并数据以及2011 - 2012年EHR邮件调查的数据。对样本数据进行加权以得出门诊医生特征及其执业情况的全国估计值。
2012年，71.8%的门诊医生报告使用了任何类型的EHR系统，高于2007年的34.8%。2012年，39.6%的医生拥有具备基本系统标准功能的EHR系统，高于2007年的11.8%；2012年，23.5%的门诊医生拥有具备全功能系统标准功能的EHR系统，高于2007年的3.8%。2007年，在拥有11名或更多医生的执业机构中的医生（74.3%）与规模较小执业机构中的医生（个体执业医生中为20.6%）在使用任何类型EHR系统方面存在巨大差距；然而，在2007 - 2012年期间这一差距缩小了。2007年，在采用全功能系统方面，初级保健医生（4.7%）和非初级保健医生（2.8%）之间未观察到显著差距；然而，随着时间推移这一差距扩大了（2012年为27.9%对19.4%）。2007年，在拥有11名或更多医生的执业机构中的医生与个体执业医生在采用全功能系统方面的差异为10.4个百分点；2012年这一差距扩大到30.6个百分点。
