JAMIA reports it will be 2024 by the time EHR adoption will reach its full potential

Statistical modeling in the recent JAMIA article Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless? presents some interesting results.

The study focused on small practices (where most of our EHR adoption trouble happens) and used EHR adoption data from six previous studies to estimate potential future market penetration rates.

Based on their conservative models, they said:

Under current conditions, EHR adoption will reach its maximum market share in 2024 in the small practice setting.

They concluded:

The promise of improved care quality and cost control has prompted a call for universal EHR adoption by 2014. The EHR products now available are unlikely to achieve full diffusion in a critical market segment within the time frame being targeted by policy makers.

Definitely an article worth checking out. It’s great to see the authors put some real math and science behind their predictions instead of just wishful thinking like many vendors are doing.

I, for one, think even 2024 might be too optimistic :-).

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6 thoughts on “JAMIA reports it will be 2024 by the time EHR adoption will reach its full potential

  1. I expect that most small practices will have an EHR, but I don’t think that most will be using it. I think it will be similar to the hospitals who spend millions on an EMR and then only use part or scrap the system after it fails.


  2. Great story. I had missed that one. Throughout my career as a CIO I have always given the same answer when asked “When will we have an Electronic Medical Record?” I would always say 5 years. Not because that was the right answer, but because I knew they needed an answer that seemed like it was within reach while I needed it to be far enough in the distance where they would forget the question. The fact is, they couldn’t hanlde the truth.

  3. Predictions on the penetration and use of technology are quite difficult, and I am not sure a statistical approach– using the past to predict the future– will yield an accurate answer. Certainly, how poorly EHRs have fared in the small practice setting does not give anyone much hope in the next five years.

    Looking at history: 20 years ago, the Macintosh, with its GUI interface, was out. 10 years ago, the WWW was gaining momentum. Each redefined the way we use computers. Today, it appears that open source / social apps, i.e., collaborative software (e.g., Google Maps API, Wikipedia, etc.) efforts are creating applications of great utility.

    This implies that we will have to wait ten more years before we will have another disruptive method that changes the way we use computers. I am rooting for a substantive change in ease of use– specifically an intuitive interface. The truth is, using a computer is as hard today as it was 20 years ago. When the way we interact with computers change, doctors, even as late adopters, will adopt EHRs in their practices. Right now, EHRs are huge impediments to getting anything done.

  4. Will (CandidCIO), you’re right — always giving a sliding window of 5 years is a good bet because if you gave anything longer people would think you were a cynic instead of a realist.

    Jsytsai, you made a good point saying “I am not sure a statistical approach– using the past to predict the future– will yield an accurate answer.” And, of course you are correct that it may not be the accurate answer. But, with math and science we’ll get a more accurate answer than we would through most pundit’s guesses. Ultimately no one knows when successful EHR adoption will “happen” since there’s no real definition of success yet.

  5. Keep your eyes on Medsphere’s EHR (not a plug for medsphere). They have an interesting approach used by companies like Redhat in using the open source vista product (VA hospital release). I’ve installed both the hospital and physician practice versions and they are marginal at best. Medsphere is backed by a lot of VC cash which means all the development they do on product goes back into the open source community that anyone can use. This might facilitate some sort of standard.

    I’m told from insiders at two of the large enterprise vendors that this has them scared because of the large number of physicians having exposure through their residencies at VA hospitals. They are more likely to go with a system they are familiar with and is touted as a free application. Although not truly free, this could give the EHR market an open source standard to build on…..The open source version is scheduled for general release late this year. Medsphere is selling their version now.


  6. Will, you are quite right — the big vendors should be scared of MedSphere. I agree with you that the products are marginal (especially installation and deployment but interoperability is hard, too). But, being marginal is ok since they are free of license costs.

    Health IT systems are born to be open source: there is so much customization, integration, and deployment work necessary that maintenance is where the money is anyway. By using an open source systems MedSphere and other companies like that have very little sales costs, very little marketing costs but can still rake in maintenance and support fees. The big boys should definitely be concerned in the 3-5 year time horizon.

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