EHR adoption grows for rural doc practices, reversing trend

Physician electronic health record adoption is "significantly" higher in rural areas than in urban ones, reversing a trend and signaling an important shift in adoption, according to a new study in the Journal of the American Medical Informatics Association (JAMIA).

The study, of more than 1 million physicians in 270,000 offices in the U.S. in 2012, found that at a national level, EHR adoption in rural areas was 56 percent compared to 49 percent in urban ones. This was true for all primary care practices, most specialists and most practice sizes. Twenty-seven states have adoption rates statistically higher in rural areas then in their urban ones; only two states, Vermont and Connecticut had higher rates in urban areas.  

Moreover, only 14 percent of the gap between rural and urban practices could be attributable to differences in the practices themselves, such as lower patient volume or size of practice, according to the study.

The study credits the higher adoption rate in rural areas in large part to the success of the regional extension centers (RECs), which focused on supporting primary care practices in rural areas. The RECs have been recognized as being instrumental in helping physicians adopt EHRs.

Rural physicians also may be more aware of the benefits of EHRs, or more interested in the payment incentives of the Meaningful Use program, because they had fewer resources to adopt health IT.

The study recommends that RECs focus on areas and specialties with lower adoption rates.

"Importantly, practice-level EMR adoption rates are still below 50 percent for numerous specialties and still lag dramatically for solo practitioners, which reaffirms the need for direct research on why individual practices chose to adopt," the study's authors said. 

There has been concern that without continued support, low resource physician practices may not be able to maintain their EHR systems and progress further with health IT. It does appear that most RECs intend to remain operational, even though their grant money ended in 2014.

To learn more:
- read the study

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