Journal of General Internal Medicine

, Volume 29, Issue 10, pp 1341–1348 | Cite as

Does it Get Easier to Use an EHR? Report from an Urban Regional Extension Center

  • Mandy Smith Ryan
  • Sarah C. Shih
  • Chloe H. Winther
  • Jason J. Wang
Original Research



Little is known about whether more experience with an electronic health record (EHR) makes it easier for providers to meaningfully use EHRs.


To assess whether the length of time that small practice providers have been using the EHR is associated with greater ease in performing meaningful use-related tasks and fewer EHR-related concerns.


We administered a web-based survey to 400 small practice providers in medically underserved communities in New York City participating in an EHR implementation and technical assistance project. We used logistic regression to estimate the association between the length of time a provider had been using the EHR (i.e., “live”) and the ease of performing meaningful use-related tasks and EHR-related concerns, controlling for provider and practice characteristics.


Compared to providers who had been live 6 to 12 months, providers who had been live 2 years or longer had 2.02 times greater odds of reporting it was easy to e-prescribe new prescriptions (p < 0.05), 2.12 times greater odds of reporting it was easy to e-prescribe renewal prescriptions (p < 0.05), 2.02 times greater odds of reporting that quality measures were easy to report (p < 0.05), 2.64 times greater odds of reporting it was easy to incorporate lab results as structured data (p < 0.001), and 2.00 times greater odds of reporting it was easy to generate patient lists by condition (p < 0.05). Providers who had been live 2 years or longer had 0.40 times lower odds of reporting financial costs were a concern (p < 0.001), 0.46 times lower odds of reporting that productivity loss was a concern (p < 0.05), 0.54 times lower odds of reporting that EHR unreliability was a concern (p < 0.05), and 0.50 times lower odds of reporting that privacy/security was a concern (p < 0.05).


Providers can successfully adjust to the EHR and over time are better able to meaningfully use the EHR.


electronic health records primary care population health physician satisfaction vulnerable populations 



The authors would like to thank those who served on the Survey Development Group at PCIP, including Sheila Anane and Rachel Helfont and Dr. Larry Casalino, Dr. Tara Bishop, and Dr. Amanda Parsons for guidance in designing the survey. Thanks to Samantha Catlett and Maryam Khan for assistance with data collection and Brent Stackhouse for help obtaining survey honoraria. Thanks to the many people who tested the survey, including members of our Provider Advisory Board and PCIP staff. We would like to thank Dr. Andrew Ryan for helpful comments on the paper.

Conflict of Interest

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


The New York City Tax Levy and the Office of the National Coordinator (ONC) for Health Information Technology funded the survey and supported the salaries of staff to conduct this study.

Supplementary material

11606_2014_2891_MOESM1_ESM.doc (342 kb)
ESM 1(DOC 342 kb)


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Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  • Mandy Smith Ryan
    • 1
  • Sarah C. Shih
    • 1
  • Chloe H. Winther
    • 1
  • Jason J. Wang
    • 1
  1. 1.New York City Department of Health and Mental HygienePrimary Care Information Project (PCIP)Long Island CityUSA

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