Journal of General Internal Medicine

, Volume 28, Issue 7, pp 957–964 | Cite as

Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

  • Vaishali PatelEmail author
  • Eric Jamoom
  • Chun-Ju Hsiao
  • Michael F. Furukawa
  • Melinda Buntin
Health Policy



Federal initiatives are underway that provide physicians with financial incentives for meaningful use (MU) of electronic health records (EHRs) and assistance to purchase and implement EHRs.


We sought to examine readiness and interest in MU among primary care physicians and specialists, and identify factors that may affect their readiness to obtain MU incentives.


We analyzed 4 years of data (2008–2011) from the National Ambulatory Medical Care Survey (NAMCS) Electronic Medical Record (EMR) Supplement, an annual cross-sectional nationally representative survey of non-federally employed office-based physicians.


Survey-weighted EHR adoption rates, potential to meet selected MU criteria, and self-reported intention to apply for MU incentives. We also examined the association between physician and practice characteristics and readiness for MU.


The overall sample consisted of 10,889 respondents, with weighted response rates of 62 % (2008); 74 % (2009); 66 % (2010); and 61 % (2011). Primary care physicians’ adoption of EHRs with the potential to meet MU nearly doubled from 2009 to 2011 (18 % to 38 %, p < 0.01), and was significantly higher than specialists (19 %) in 2011 (p < 0.01). In 2011, half of physicians (52 %) expressed their intention to apply for MU incentives; this did not vary by specialty. Multivariate analyses report that EHR adoption was significantly higher in both 2010 and 2011 compared to 2009, and primary care physicians and physicians working in larger or multi-specialty practices or for HMOs were more likely to adopt EHRs with the potential to meet MU.


Physician EHR adoption rates increased in advance of MU incentive payments. Although interest in MU incentives did not vary by specialty, primary care physicians had significantly higher rates of adopting EHRs with the potential to meet MU. Addressing barriers to EHR adoption, which may vary by specialty, will be important to enhancing coordination of care.


electronic health records adoption physician primary care meaningful use 




The Office of the National Coordinator (ONC) for Health Information Technology at the U.S. Department of Health and Human Services funded the survey and supported the salaries of ONC and National Center for Health Statistics staff to conduct this study.

Conflict of Interest

The authors declare that they do not have conflict of interest.

Prior Presentations

This paper was presented as an oral presentation at the AcademyHealth Annual Research Meeting, in Seattle in June, 2011.

Supplementary material

11606_2012_2324_MOESM1_ESM.pdf (24 kb)
Appendix Table 1 MU Criteria to National Ambulatory Medical Care Survey EMR Supplement MU Final Rule (PDF 24 kb)
11606_2012_2324_MOESM2_ESM.pdf (26 kb)
Appendix Table 2 Physician Characteristics: Primary Care Specialty Versus Other Specialties, 2008–2011 (PDF 26 kb)
11606_2012_2324_MOESM3_ESM.pdf (31 kb)
Appendix Table 3 Multivariate Analyses: Factors Significantly Associated with Physician Adoption of “Any” and “Basic” EHRs (p <  0.05) (PDF 31 kb)


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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Vaishali Patel
    • 1
    Email author
  • Eric Jamoom
    • 2
  • Chun-Ju Hsiao
    • 2
  • Michael F. Furukawa
    • 1
  • Melinda Buntin
    • 3
  1. 1.Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human ServicesWashingtonUSA
  2. 2.National Center for Health Statistics (NCHS), U.S. Department of Health and Human ServicesWashingtonUSA
  3. 3.Congressional Budget OfficeWashingtonUSA

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