Health Information Technology

A survey of states' adoption of health information technology, included methodology and percent of prescriptions transmitted electronically.

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Adoption and use of electronic health records (EHRs) are still limited.

  • An estimated 28 percent of doctors nationwide currently use EHRs. In California, the leader in EHRs, 37 percent of doctors use them.1 A recent survey showed that only 1.5 percent of U.S hospitals have a comprehensive EHR system, while an additional 7.6 percent have a basic system.2 Studies show total costs for implementing office-based EHRs range from $25,000 to $45,000 per physician. Annual costs for operating and maintaining such systems are from $3,000 to $9,000 per physician.3
  • The American Recovery & Reinvestment Act of 2009 provides $19 billion in financial incentives through the Medicare program to encourage physicians and hospitals to adopt and use certified EHRs and authorizes competitive grants to states for loans to providers.4

The creation of statewide health information exchanges and regional health information organizations is helping to connect those records.

  • Delaware is widely recognized as the first state to make significant progress in implementing a statewide health information exchange.5
  • Many other states are taking a different route, seeking to build statewide networks by incubating regional health information organizations.
  • An estimated 145 of these organizations were formed around the country in recent years. A 2008 survey assessed the progress of 130 of these efforts and found that 42 were operational, 39 were just getting started, and 36 were in the process of implementation. The survey included 18 initiatives that were new since 2007.6

Electronic prescribing is a reality in all states but some are doing more than others.

  • As of August 2007, all 50 states plus Washington, D.C., allow physicians and pharmacists to electronically exchange prescriptions. As late as 2004, approximately half the states had laws that were incompatible with e-prescribing.7
  • Massachusetts is the number one e-prescribing state in the nation. More than 20 percent of total prescriptions were routed electronically in 2008, twice as many as the number three state of Michigan.8
  • An estimated 68 million prescriptions were routed electronically between e-prescribing providers and pharmacists in 2008, up from 29 million in 2007.9
  • Despite that growth, it represented only a shift from 2 percent of eligible prescriptions to 4 percent. There were 1.57 billion new prescriptions and renewals eligible for electronic routing in 2008.9
  • A program called the National E-Prescribing Patient Safety Initiative makes Web-based e-prescribing available to prescribers for free. More fully functional e-prescribing applications are available from $500 to $2,500 per year.4

  Download the Excel Version of the Table: "Health Information Technology Adoption"


1 California HealthCare Foundation. “Snapshot: The State of Health Information Technology in California.” 2008.
2 Jha, Dr. Ashish, et al. “Use of Electronic Records in Hospitals.” New England Journal of Medicine 360 (2009).
3 eHealth Initiative. “Electronic Prescribing: Becoming Mainstream Practice.” June 2008.
4 American Medical Association. “American Recovery & Reinvestment Act of 2009: Summary of Major Health Care Provisions.”
5 Nancy Ferris. “Delaware First With Statewide Health Information Exchange.” Government Health IT. March 28, 2007.
6 eHealth Initiative. “Fifth Annual Survey of Health Information Exchange At the State and Local Levels.” September 2008.
7 SureScripts. “National Progress Report on E-Prescribing.” December 2007.
8 SureScripts. “The Fourth Annual Safe-Rx Awards.” 2009. Accessed from:
9 SureScripts. “National Progress Report on E-Prescribing.” 2009 Accessed from: .
10 “Regional Health Information Organizations in the United States.”
11 eHealth Initiative. “Fourth Annual Survey of Health Information Exchange at the State, Regional and Community Levels.”

HealthIT.xls23.5 KB
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