More than two-thirds of family doctors now use electronic health records, and the percentage doing so doubled between 2005 and 2011, a new study finds.

If the trend continues, 80 percent of family doctors — the largest group of primary care physicians — will be using electronic records by 2013, the researchers predicted.

The findings provide "some encouragement that we have passed a critical threshold," said study author Andrew Bazemore, M.D., director of the Robert Graham Center for Policy Studies in Primary Care, in Washington, D.C. "The significant majority of primary care practitioners appear to be using digital medical records in some form or fashion."

The promises of electronic record-keeping include improved medical care and long-term savings. However, many doctors were slow to adopt these records because of the high cost and the complexity of converting paper files. There were also privacy concerns.

"We are not there yet," Dr. Bazemore added. "More work is needed, including better information from all of the states."

The Obama administration has offered incentives to doctors who adopt electronic health records, and penalties to those who do not.

For the study, researchers mined two national data sets to see how many family doctors were using electronic health records, how this number changed over time, and how it compared to use by specialists. Their findings appear in the Annals of Family Medicine.

Nationally, 68 percent of family doctors were using electronic health records in 2011, they found. Rates varied by state, with a low of about 47 percent in North Dakota and a high of nearly 95 percent in Utah.
Michael Oppenheim, M.D., vice president and chief medical information officer for North Shore Long Island Jewish Health System in Great Neck, N.Y., said electronic record-keeping streamlines medical care.

These records "eliminate handwriting errors, and help with planning and caring for patients with chronic medical problems," Dr. Oppenheim said. Plus, the files can be accessed by a doctor when the initial provider is unavailable, he said.

Electronic health records also save money in the long term, he noted. "If a patient has a complaint and just had a blood test, and then shows up at the ER [emergency room] with the same complaint, the ER doctor can access the record and not reorder the same test," he said.

Oppenheim said medical penalties are driving adoption of e-records, but there is still some hesitancy. "Doctors are nervous about the cost and worried about how it will affect their practice," he said. "The conversion process is complex."

Doctors can do it themselves or outsource the system. "You pay in productivity or dollars," he said.
Electronic health records are good news for all involved, agreed Adam Szerencsy, M.D., an internist at NYU Medical Center in New York City and the Epic Medical Director there. Epic is NYU's electronic health record system.

When the concept first surfaced, many patients were concerned about their privacy. Today's electronic health records are secure and often have protocols attached to make sure that they don't fall into the wrong hands, he explained.

A key reason that family doctors are leading the transition is that government incentives make it a little more lucrative for family practitioners than specialists, he said.

Also, "primary care doctors manage patients over time, while subspecialists usually don't," Dr. Szerencsy said. For example, a surgeon may treat appendicitis, and then the case is closed.

The Holy Grail is thought to be a universal health record where doctors everywhere can access patient records. "We are getting closer," Dr. Szerencsy said. "Within the next couple of years, electronic health records will explode across the board."