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Factors and Forces Affecting EHR System Adoption: Report of a 2004 ACMI Discussion

Affiliations of the authors: Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, OR (JSA); Division of General Internal Medicine, Brigham and Women's Hospital, Partners Healthcare and Harvard Medical School, Boston, MA (DWB).

Correspondence and reprints: Joan S. Ash, PhD, Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098; e-mail: <ash{at}ohsu.edu>.

Received for publication: 08/31/04; accepted for publication: 09/21/04.

Abstract

After the first session of the American College of Medical Informatics 2004 retreat, during which the history of electronic health records was reviewed, the second session served as a forum for discussion about the state of the art of EHR adoption. Adoption and diffusion rates for both inpatient and outpatient EHRs are low for a myriad of reasons ranging from personal physician concerns about workflow to broad environmental issues. Initial recommendations for addressing these issues include providing communication and education to both providers and consumers and alignment of incentives for clinicians.