Charting Change: The Growth of Electronic Health Records

Reviewed by Abbie Jacobs, RN, BSN


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Charting Change: The Growth of Electronic Health Records

As part of the 2009 economic stimulus, healthcare providers around the country have been establishing policies governing the use of digital medical records. What does the law say and how are healthcare providers changing their practices to comply?

Understanding the Law

The American Recovery and Reinvestment Act of 2009 establishes mandates and incentives for healthcare providers, depending on the types of medical records they use:

Electronic medical records (EMR)

What is it? Digital version of traditional paper charts; contains treatment history of patients in one practice; don’t transfer from one practice to another. (1)

What’s the law? Mandated “meaningful use” for all public and private healthcare providers in order to maintain existing Medicare and Medicaid reimbursement levels. (2)

Electronic health records (EHR)

What is it? Contains treatment history of patients from all clinicians involved in patient’s care; designed to enable sharing of information across providers, such as labs and specialists. (1)

What’s the law? Financial incentives for providers who can prove “meaningful use” of such records. (2)


They’ve had five years to begin implementing digital records; how are hospitals doing in fulfilling the government’s mandates?


Acute-care hospitals with at least a basic electronic health record (3)

1 in 4

Hospitals with a comprehensive EHR that includes: (3, 4)

  • Physician and nurse notes
  • Advance directives
  • Radiologic and diagnostic test images
  • Consultant reports

At least basic adoption by … (3)

… hospital size

Large: 73%

Medium: 62%

Small: 53%

… teaching status

Major teaching: 77%

Minor teaching: 65%

Nonteaching: 56%

… ownership

Nonprofit: 63%

Public: 55%

For-profit: 48%

… geographic region

Midwest: 60%

West: 60%

Northeast: 57%

South: 57%

Doctors’ Offices

What about office-based physicians? What progress have they made in the past half-decade?

3 in 4

Doctors’ offices with at least basic electronic health records (3)

At least basic adoption by … (3)

… age

Under 50: 50%

50 and older: 47%

… practice size

1: 37%

2-5: 44%

6-10: 60%

11+: 66%

… practice type

Single specialty: 45%

Multi-specialty: 59%

… geographic region

Northeast: 44%

South: 47%

West: 49%

Midwest: 54%