State-Level EHR Adoption: Analysis of the 2015 NEHRS Survey Data

This report presents an analysis of the 2015 National Electronic Health Records Survey (NEHRS), focusing on the adoption of Electronic Health Records (EHR) by office-based physicians across the United States. The NEHRS, conducted by the National Center for Health Statistics, provides nationally representative data on EHR adoption at both national and state levels. The survey assesses the use of any EHR/EMR system, basic systems (defined by functionalities like patient history, problem lists, and e-prescribing), and certified systems (meeting meaningful use criteria). The report includes a table detailing the percentage of physicians using each type of system by state, highlighting statistically significant differences from the national average. It references the criteria for certified systems and meaningful use as defined by the Department of Health and Human Services and provides a citation for the data source. This document offers valuable insights into the state of EHR adoption in 2015.

National Electronic Health Records Survey: 2015 State and National
Electronic Health Record Adoption Summary Tables
We are pleased to release the most current nationally representative data on electronic health record (EHR)
adoption by office-based physicians in the United States. Statistics are presented on data collected in the
2015 National Electronic Health Records Survey (NEHRS). NEHRS, which is conducted by the National
Center for Health Statistics and sponsored by the Office of the National Coordinator for Health Information
Technology, is a nationally representative mixed mode survey of office-based physicians that collects
information on physician and practice characteristics, including the adoption and use of EHR systems.
NEHRS sampling design allows for both national and state-based estimates of EHR adoption. NEHRS is
conducted annually as a sample survey of nonfederal office-based patient care physicians, excluding
anesthesiologists, radiologists, and pathologists.
The 2015 NEHRS sample consisted of 10,302 office-based physicians. Nonrespondents to the mail survey
received follow-up telephone calls. The 2015 NEHRS data collection took place from August through
December 2015, and used a sequential mixed mode design to collect data through web, mail, and phone.
Using a physician database, email addresses of sampled physicians were identified. Sampled physicians that
did not have an email match were asked to complete the survey by mail or phone. Among those with email
addresses, respondents were randomly assigned to one of four groups: an invitation to take the web survey
through email, US mail, both, or no web survey option. Nonresponse to the web survey resulted in 3
mailings of the questionnaire followed by phone contacts.
Sampled physicians were able to complete the survey through web, mail and phone. The overall unweighted
response rate of the 2015 NEHRS questionnaire was 51.9% (49.2% weighted). A copy of the 2015 NEHRS
questionnaire is available from the NCHS website.
This table provides national and state-based estimates of office-based physicians’ adoption of electronic
health record/electronic medical record (EHR/EMR) systems. A basic system is a system that has all of the
following functionalities: patient history and demographics, patient problem lists, physician clinical notes,
comprehensive list of patients’ medications and allergies, computerized orders for prescriptions, and ability
to view laboratory and imaging results electronically. A certified system was defined by physicians
answering “yes” to having a current system that “meet meaningful use criteria defined by the Department of
Health and Human Services.” For more information on certified systems and meaningful use criteria go to
the Centers for Medicare & Medicaid Services Official Web site for the Medicare and Medicaid EHR
Incentive Programs (https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms). National
estimates represent all states and the District of Columbia. Statistically significant differences between
estimates and the national percentage are calculated by using statistical tests with 0.05 significance level.

Table. Percentage of office-based physicians using any EHR/EMR, physicians that have a basic system,
and physicians that have a certified system, by state: United States, 2015
State
Any EHR or EMR1
system Basic system Certified system
Percent Percent Percent
United States 86.9 53.9 77.9
Alabama 83.4 36.5§ 78.1
Alaska 82.9 46.4 71.2
Arizona 79.8 50.4 74.4
Arkansas 96.2† 45.6 85.3
California 82.1 49.4 76.5
Colorado 93.1 60.2 89.6†
Connecticut 82.6 46.8 74.8
Delaware 98.8† 54.4 82.6
District of Columbia 76.4 44.4 66.3
Florida 84.7 48.1 79.1
Georgia 78.3 50.8 69.3
Hawaii 86.6 55.8 70.8
Idaho 88.9 47.0 81.2
Illinois 87.0 68.5† 73.5
Indiana 95.4† 68.9† 88.8†
Iowa 91.3 66.9† 80.8
Kansas 91.5 69.4† 83.0
Kentucky 96.8† 53.6 84.2
Louisiana 74.8§ 40.3§ 69.3
Maine 83.1 45.2 73.4
Maryland 82.5 48.3 73.4
Massachusetts 94.9† 49.4 89.9†
Michigan 90.3 62.8 84.9
Minnesota 97.7† 79.2† 88.9†
Mississippi 87.9 63.7 82.8
Missouri 90.0 60.0 78.6
Montana 83.3 67.2† 74.7
Nebraska 94.2† 56.9 87.1†
Nevada 82.7 40.5 72.3
New Hampshire 92.2 71.5† 81.8
New Jersey 75.3§ 33.3§ 61.6§
New Mexico 95.0† 72.6† 82.2
New York 86.4 48.2 74.5
North Carolina 97.1† 66.4† 89.4†
North Dakota 93.5 78.1† 83.8
Ohio 87.1 54.7 76.4
Oklahoma 87.1 52.1 77.1
Oregon 83.6 64.8 77.7

Pennsylvania 83.4 50.0 72.7
Rhode Island 77.4 46.9 69.0
South Carolina 85.9 48.3 76.8
South Dakota 97.5† 72.7† 90.4†
Tennessee 87.4 49.5 80.2
Texas 93.4 54.1 79.0
Utah 87.4 69.1† 73.4
Vermont 85.8 52.3 79.3
Virginia 85.9 55.4 73.4
Washington 92.7 56.9 85.7
West Virginia 83.4 56.8 75.3
Wisconsin 93.2 78.6† 83.2
Wyoming 90.1 58.8 88.4†
†Percentage is higher than national percentage (p<0.05).
§ Percentage is lower than national percentage (p<0.05).
1EHR/EMR is electronic health record/electronic medical record.
NOTE: A basic system is a system that has all of the following functionalities: patient history and
demographics, patient problem lists, physician clinical notes, comprehensive list of patients’
medications and allergies, computerized orders for prescriptions, and ability to view laboratory and
imaging results electronically. A certified system was defined by physicians answering “yes” to having
a current system that “meet meaningful use criteria defined by the Department of Health and Human
Services.” For more information on certified systems and meaningful use criteria go to the Centers for
Medicare & Medicaid Services Official Web site for the Medicare and Medicaid EHR Incentive Programs
((https://www.cms.gov/Regulations-and-
Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms).
National estimates represent all states and the District of Columbia.
SOURCE: NCHS, National Electronic Health Records Survey. 2015.
Suggested citation: Jamoom E, Yang N. Table of Electronic Health Record Adoption and Use among
Office-based Physicians in the U.S., by State: 2015 National Electronic Health Records Survey. 2016.