Journal of General Internal Medicine

, Volume 29, Issue 10, pp 1387–1387 | Cite as

Capsule Commentary on Ryan et al., Does it get easier to use an EHR? Report from an Urban Regional Extension Center

Capsule Commentary

In 2011, the federal government began offering incentives for providers to adopt electronic health records (EHRs).1 While the goal was to improve patient safety and quality, previous studies have had mixed results.2,3 This study by Ryan et al. evaluated whether time using an EHR correlated with increased ease of use for meaningful use-related tasks.4

After 2 years or more of EHR use, small-practice providers were more comfortable using the system to e-prescribe, order lab or radiology tests, incorporate lab results and order preventative services during visits. The authors also found that concerns about financial costs and loss of productivity seemed to dissipate as providers used the EHR. While other tasks deemed “meaningful use,” such as generating patient lists by condition and reporting quality measures, became easier with more time using the EHR, they remained “not easy” for the majority of providers surveyed.

The study is not longitudinal, meaning it is impossible to say whether providers truly became more comfortable with tasks over time or if there may have been bias in unmeasured differences between the early and late adopters of the EHR. However, even if one assumes that it gets easier to use an EHR over time, it is notable how few providers felt comfortable with some key aspects of the system. This finding was especially pronounced in the low rate of respondents who felt that care coordination tasks were easy. This is unfortunate, since care coordination is a key component of the second stage of the EHR incentive program, which began this year.5

Federal policies have significant impacts on medical providers and regulatory agencies need data to inform future policy decisions. This must include studies that explore providers’ experiences. Small-practice providers are a particularly important group to study, as they may face substantial challenges in EHR adoption. This study asks the interesting question of whether or not the system gets easier to use “meaningfully” over time. The answer is mostly yes, but unfortunately, easier does not necessarily equate with easy.


Conflict of Interest

The author has no conflicts of interest with this article.


  1. 1.
    Blumenthal D. Launching HITECH. N Engl J Med. 2010;362:382–38.PubMedCrossRefGoogle Scholar
  2. 2.
    Ryan AM, Bishop TF, Shih S, Casalino LP. Small physician practices in New York needed sustained help to realize gains in quality from use of electronic health records. Health Aff (Millwood). 2012;32:53–62.CrossRefGoogle Scholar
  3. 3.
    Zhou L, Soran CS, Jenter CA, et al. The relationship between electronic health record use and quality of care over time. J Am Med Inform Assoc. 2009;16:457–64.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Ryan MS, Shih SC, Winther CH, Wang JJ. Does it get easier to use an EHR? Report from and Urban Regional Extension Center. J Gen Intern Med. DOI: 10.1007/s11606-014-2891-0.
  5. 5.
    Office of the National Coordinator. Meaningful Use Stage 2. Available at: Accessed May 29th, 2014.

Copyright information

© Society of General Internal Medicine 2014

Authors and Affiliations

  1. 1.Department of MedicineOregon Health and Sciences UniversityPortlandUSA

Personalised recommendations