My answer as of 2015
In 2008, 4% of U.S. physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system, according to the New England Journal of Medicine, see Common Examples of Healthcare IT Failure (Drexel University).
By May 2013, approximately 90% of health care facilities had implemented an electronic health record (EHR) system although only 56% of long-term care facilities had done so, see Long-term care facilities lag behind on EHR adoption.
As for physicians, CDC Releases Report on Physician EHR Adoption in 2014 indicated an EHR adoption rate of 78%. Here is some data about physicians' usage of digital records and technology via Survey shows EHR skepticism increasing among U.S. doctors published 15 April 2015.
The number of U.S. doctors who routinely use digital tools, such as secure email, for communicating with patients is 30% now versus 13% in 2012.
The five IT capabilities that U.S. doctors use the most are:
- entering patient notes electronically (82%);
- prescribing drugs electronically (72%);
- receiving clinical results directly into a patient’s EMR (65%);
- using electronic administration tools (63%);
- sending e-order requests to labs (62%).
I don't know the composition of the complementary data. It depends on the number of N/A or "didn't know" or "didn't respond to that question" versus "I use paper" responses.
A note about terminology
An EMR is an Electronic Medical Record. An EHR (Electronic Health Record) system consists of either EMRs or EHRs, i.e. they are used interchangeably. I don't often see "EMR systems". I'm unsure why "EHR systems" is the more common term. Often, context is necessary to determine whether "EHR" refers to an EHR system or an EHR.
Why don't physicians want to use digital records?
EHR’s disruption of normal work flow can have disastrous medical consequences, as in the Dallas Ebola case, which was an unusually visible example but quite common.
Costs of IT failures
These are three of many instances.
Sutter Health reported that the EHR system they paid nearly $1 billion for crashed in late August 2013 for eight hours during a system upgrade. Several large hospitals had no access to ANY medical records for eight hours. Epic Problems or Epic Results.
Wake Forest Baptist Medical Center reported huge losses, over $60 million, since its adoption of EHR. As a result, 950 jobs were cut and the hospital must reduce hours of service. Wake Forest’s Epic woes continue with slashed worker raises
Antelope Valley Hospital in California shut down its emergency department for an entire day after the EHR and data system failed. The failed systems led to issues with properly dispensing medications, verifying physician orders, reviewing patient labs, MRIs and other diagnostic procedures, and led to an inability for clinicians to review patient records, according to hospital nurses. Additionally, the hospital did not have a backup plan in place. EHR failure closes California hospital Emergency Department, nurses ask for investigation
EHR security vulnerabilities
There are huge financial and even operational penalties associated with data breaches of PHI (personal health information). See Why Doctors Don't Like Electronic Health Records via MIT Technology Review.
Negative impact on patient care due to EHR design problems
Nowadays, medical notes consist of randomly pre-populated check box data lifted from multiple author sources and vomited into a nonsensical monstrosity of a run-on sentence. It’s almost impossible to figure out what the physician makes of the patient or what she is planning to do. Occasional “free text” boxes can provide clues, when the provider has bothered to clarify.
One needs to be a medical detective to piece together an assessment and plan these days. It’s both embarrassing and tragic…if you believe that the purpose of medical notes is effective communication. The Medical Chart: Ground Zero For The Deterioration Of Patient Care
EMR Alert - Featuring radiologist note in illegible font color
More Unintended Consequences Of Digital Data: How An EMR Gave My Patient Syphilis
At one hospital, the process for discharging a patient requires that the physician type all the discharge summary information into the EMR and then read it into a dictation system so that it can be transcribed by a team in India (cheaper than US transcription service) and returned to the hospital in another part of the EMR. The physician then needs to go into the new document and remove all the typos and errant formatting so that it resembles their original discharge summary note. In one of my recent notes the Indian transcriptionist misheard my word for “hydrocephalus” and simply entered “syphilis” as the patient’s chief diagnosis.
Another hospital has an entire wing of its main building devoted to an IT team. I accidentally discovered their facility on my way to radiology. Situated in a dark room surrounded by enough flat panel monitors to put a national cable network to shame, about 40 young tech support engineers were furiously working to keep the EMR from crashing on a daily basis–an event which halts all order processing from the ER to the ICU. Ominous reports of the EMR’s instability were piped over the entire hospital PA system, warning staff when they could expect screen freezes and data entry blockages.
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