Factors influencing family physician adoption of electronic health records (EHRs)

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.