An increasing trend in EMR/EHR system use among office-based physicians was noted from 2001 through preliminary 2011 estimates. In 2011, the NAMCS mail survey showed about 57% of office-based physicians used any EMR/EHR system, a 12% increase from the 2010 estimate. Between 2010 and 2011, the percentage of physicians who reported having systems meeting the criteria for a basic system increased 36%. Adoption of EMR/EHR systems varied greatly by state. In 2011, the percentage of physicians using any EMR/EHR system ranged from 40% in Louisiana to 84% in North Dakota. Compared with the national average, 3 states had a significantly lower percentage of office-based physicians using any EMR/EHR system, and 11 states had a significantly higher percentage. The percentage of physicians having a system that met the criteria for a basic system ranged from 16% in New Jersey to 61% in Minnesota. Compared with the national average, six states had a significantly lower percentage of office-based physicians with a basic system, and eight states had a significantly higher percentage. In 2011, 52% of physicians reported intending to apply for the Medicare or Medicaid EHR incentive payments, a 26% increase from 2010. In 2010, interest among physicians in applying for meaningful use incentive payments was similar to the national average (41%) across most states. In only four states (Alaska, New York, North Dakota, and West Virginia) and the District of Columbia was the percentage lower than the national average. To qualify for Stage 1 meaningful use incentive payments, eligible physicians need to meet all 15 Stage 1 Core Set objectives and 5 of 10 Menu Set objectives, using certified EHR systems (see "Definitions"). In this report, estimates of physicians’ readiness to meet Stage 1 Core Set meaningful use measures were limited to data collected on the computerized functions needed to meet eight Stage 1 objectives. A previous study found that 15% of physicians eligible to apply for meaningful use incentives had EHR systems with basic functions capability (3). In the present study, 43% of physicians planning to apply for incentives had EHR systems with functions that would allow them to meet eight Stage 1 Core Set meaningful use objectives. In 2010, the percentage of physicians planning to apply for incentives with EHR systems able to support eight Stage 1 Core Set objectives exceeded the national average in eight states (Iowa, Maine, Massachusetts, Minnesota, Oregon, Utah, Washington, and Wisconsin) and was below the national average only in Texas. The 2010 estimates represent an overestimate of physician readiness because not all physicians with systems supporting all eight objectives examined in this report have systems also capable of supporting the remaining seven Core Set objectives and 5 of 10 Menu Set objectives required for payment. As federal programs to provide incentives for meaningful use and local technical support are implemented, monitoring EHR system adoption will continue to be important in evaluating the effectiveness of these policies and targeting efforts in certain areas.
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