Trends in adoption of electronic health records by family physicians in Washington State

Inform Prim Care. 2009;17(3):145-52. doi: 10.14236/jhi.v17i3.729.


Objective: Electronic health record (EHR) adoption is encouraged by health plans, government agencies, and both the American Academy of Family Physicians and the Washington Academy of Family Physicians (WAFP), but rates of EHR adoption by family physicians in Washington were previously unknown. This study measured current rates of EHR adoption by family physicians in Washington State, as well as perceived barriers to adoption and what physicians identify as possible means to overcome those barriers.

Design: A survey of medical practices in Washington State was performed. One physician per practice was selected to respond on behalf of their practice for all practices where family physicians work and for which contact information was available in the databases of the Washington State Medical Association (WSMA) and WAFP. The survey was distributed either electronically or in print form depending on availability of an email address.

Measurements: Rates of EHR adoption, plans for adoption for those not yet using EHRs, perceived barriers to EHR adoption and perceived means to overcome those barriers.

Results: Response rate was 43.8%. EHR adoption by this group is relatively high at 57.9% and did not vary by practice location. Although solo practices had a relatively high rate of adoption (43.5%), EHR adoption remains strongly associated with practice size. Identified barriers to implementation are primarily financial, as are the means to overcome those barriers. If current trends continue, adoption will plateau at approximately 68% in the next four years.

Conclusions: Adoption rate appears to have peaked in this group given current constraints and barriers. Increased outreach efforts and assistance programs will be necessary to achieve EHR adoption in the remaining practices, particularly solo and small group practices.

MeSH terms

  • Attitude to Computers
  • Confidentiality
  • Diffusion of Innovation*
  • Family Practice / organization & administration*
  • Family Practice / statistics & numerical data*
  • Humans
  • Inservice Training
  • Medical Records Systems, Computerized / statistics & numerical data*
  • Professional Practice / statistics & numerical data*
  • Reimbursement Mechanisms
  • Washington