Use of electronic medical records by ambulatory care providers: United States, 2006.

OBJECTIVES This report presents 2006 information on adoption of electronic medical records (EMRs) in five ambulatory care settings. Use of EMR systems within these settings is presented by selected provider characteristics. METHODS Nationally representative estimates are from 2006 provider-based surveys, including the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Survey of Ambulatory Surgery (NSAS). RESULTS In 2006, 62.4 percent of hospital-based ambulatory surgery centers (ASCs) reported using EMR systems, almost triple the percentage reported by freestanding ASCs (22.3 percent). EMR use by hospital emergency departments (EDs) was 46.2 percent, followed by hospital outpatient departments (OPDs) (29.4 percent) and office-based physicians (29.2 percent). Based on items collected in the 2006 NAMCS, NHAMCS, and NSAS, 18.6 percent of hospital-based ASCs, 14.0 percent of hospital EDs, and 10.5 percent of office-based physicians had systems with similar features of a basic system, but only 1.7 percent of hospital EDs and 3.1 percent of office-based physicians had systems with similar features of a fully functional system. Fully functional systems are a subset of basic systems. Physicians in practices with 11 or more physicians were most likely to use EMRs (46.5 percent), whereas physicians in solo practices were least likely to use EMRs (24.0 percent). Use of EMR systems was higher among physicians located in the West (42.3 percent) than in other regions of the country (23.5 percent to 29.3 percent). EMR use did not vary by neighborhood poverty level for any of the ambulatory providers studied. From 2001 through 2005, EMR systems in hospital EDs increased by 47.2 percent. Use of EMRs among office-based physicians increased by 60.4 percent from 2001 through 2006. If those without EMR systems in 2006 with definite plans to install a system actually do so, 85.4 percent of hospital-based ASCs, 72.2 percent of EDs, 62.6 percent of OPDs, 47.3 percent of freestanding ASCs, and 47.0 percent of physicians will be using EMR systems in 2009.