Barriers to Electronic Health Record Adoption: a Systematic Literature Review <s> Introduction Rationale <s> By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care. We found that although trends in adoption of electronic health record systems across geographic regions converged from 2002 through 2011, adoption continued to lag for non–primary care specialists, physicians age fifty-five and older, and physicians in small (1–2 providers) and physician-owned practices. Federal policies are specifically aimed at encouraging primary care providers and small practices to achieve widespread use of electronic health records. To achieve their nationwide adoption, federal policies may also have to focus ... <s> BIB001 </s> Barriers to Electronic Health Record Adoption: a Systematic Literature Review <s> Introduction Rationale <s> Introduction: Electronic Medical Records (EMRs) are computerized medical information systems that collect, store and display patient information. They are means to create legible and organized recordings and to access clinical information about individual patients. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review. Aim: The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs. Method of the study: This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (EHRs) with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. Discussion: For our searches, we employed the following keywords and their combinations: physicians, electronic medical record, electronic health record, barrier, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators. <s> BIB002 </s> Barriers to Electronic Health Record Adoption: a Systematic Literature Review <s> Introduction Rationale <s> Objective: Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored. Methods: We conducted a retrospective cross-sectional study to determine the association between physician specialty and the prevalence of EHR adoption, and a retrospective serial cross-sectional study to determine the association of physician specialty and the rate of EHR adoption over time. We used the 2005–2009 National Ambulatory Medical Care Survey. We considered fourteen specialties, and four definitions of EHR adoption (any EHR, basic EHR, full EHR, and a novel definition of EHR sophistication). We used multivariable logistic regression, and adjusted for several covariates (geography, practice characteristics, revenue characteristics, physician degree). Results: Physician specialty was significantly associated with EHR adoption, regardless of the EHR definition, after adjusting for covariates. Psychiatrists, dermatologists, pediatricians, ophthalmologists, and general surgeons were significantly less likely to adopt EHRs, compared to the reference group of family medicine / general practitioners. After adjustment for covariates, these specialties were 44 – 94% less likely to adopt EHRs than the reference group. EHR adoption increased in all specialties, by approximately 40% per year. The rate of EHR adoption over time did not significantly vary by specialty. Conclusions: Although EHR adoption is increasing in all specialties, adoption varies widely by specialty. In order to insure each individual’s network of providers can electronically share data, widespread adoption of EHRs is needed across all specialties. <s> BIB003 </s> Barriers to Electronic Health Record Adoption: a Systematic Literature Review <s> Introduction Rationale <s> Background: Physician and practice characteristics associated with family physician adoption of electronic health records (EHRs) remain largely unexplored but may be important for tailoring policies and interventions. Methods: This was a cross-sectional study of EHR adoption using American Board of Family Medicine certification census data (2006–2011) for over 41,000 family physicians to test associations between demographic, geographic, and practice characteristics and EHR adoption. Results: EHR adoption rates for family physicians grew from 37% in 2006 to 68% in 2011. No significant association was found with rural status (odds ration [OR], 0.985; 95% confidence interval [CI], 0.932–1.042). Practicing in a medically underserved location (OR, 0.868; 95% CI, 0.822–0.917) or geographic health professional shortage areas (OR, 0.904; 95% CI, 0.831–0.984), or being an international medical graduate (OR, 0.769; 95% CI, 0.748–0.846) were negatively associated with adoption. Compared with physicians in group practices, physicians in solo practices (OR, 0.465; 95% CI, 0.439–0.493) and small practices (OR, 0.769; 95% CI, 0.720–0.820) were less likely to adopt EHRs, whereas those in health maintenance organizations (OR, 5.482; 95% CI, 4.657–6.454) or with faculty status (OR, 1.527; 95% CI, 1.386–1.684) were more likely. Conclusions: Variation in EHR adoption is associated with physician and practice characteristics that may help guide intervention. These findings may be important to other specialties and could instruct interventions to improve adoption. Certification boards could play an important role in tracking EHR adoption and help target resources and facilitation. <s> BIB004 </s> Barriers to Electronic Health Record Adoption: a Systematic Literature Review <s> Introduction Rationale <s> The Health Resources and Services Administration has supported the adoption of electronic health records (EHRs) by federally funded health centers for over a decade; however, little is known about health centers' current EHR adoption rates, progress toward Meaningful Use, and factors related to adoption. We analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80% of health centers reported using an EHR, and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding; however, there were small variations in adoption by total patient cost and percent of revenue from grants. Findings revealed no evidence of a digital divide among health centers, indicating that health centers are implementing EHRs, in keeping with their mission to reduce health disparities. <s> BIB005
Health information technology (HIT) and the use of electronic health records (EHRs) has increased substantially through efforts to achieve the following: reduce medical errors, provide more effective methods of communicating and sharing information among clinicians, lower national health care costs, better manage patient medical records, and improve coordination of care and health care quality BIB002 BIB003 . The Federal Government has encouraged the adoption of EHRs through incentives found within the Health Information Technology for Economic and Clinical Health (HITECH) Act, which produced Health Information Technology Regional Extension Centers (RECs). HITECH created sixty-two RECs nationwide and allocated 657 million dollars in federal funding in 2010 BIB004 . In addition, the Center for Medicare and Medicaid Services (CMS) has also facilitated the expansion of EHRs by providing incentives for adoption and meaningful use, and even penalties for lack of provider engagement BIB004 . Altogether, the United States Federal Government has invested more than twenty billion dollars to boost EHR implementation rates BIB003 . Various local initiatives have also emerged with the intent of further increasing adoption rates within their respective communities. While adoption and implementation has increased significantly within the recent years, not all hospitals and healthcare organizations have chosen to adopt an EHR system. Even with the incentives offered by the Federal Government and CMS, only one out of four hospitals in 2014 had not obtained a basic EHR system  . Studies suggest that smaller, rural hospitals are less likely to adopt as well as practices headed by physicians over the age of 55 BIB004 BIB001 BIB005 . It is also suggested that EHRs are less likely to be adopted in organizations with higher populations of low-income patients and certain states BIB004 BIB005 .