Trends in public perceptions of electronic health records during early years of meaningful use.
Surveys and Questionnaires
Attitude to Computers
Electronic Health Records
The proportion of US doctors using electronic health records (EHRs) has risen sharply in response to the federal Meaningful Use (MU) program, which incentivizes EHR adoption. To track consumer perceptions of EHRs during this period, we conducted a national telephone survey annually for 3 consecutive years, from 2011 to 2013, corresponding with the early years of MU.
Nationwide random digit-dial survey.
The survey used random digit-dial sampling on a dual frame of landline and cell phone numbers in the continental United States, but was not otherwise stratified by geographic region, race, or other variables. Because our primary goal was to identify relationships between variables and EHR attitudes, we constructed post hoc survey weights to align all 3 samples with each other. Relationships between sociodemographics and EHR questions were assessed with logistic regression models using the survey weights. Cross-year comparisons were conducted with χ2 tests and Cochran-Armitage tests for linear trend.
Between 2011 and 2013, the proportion of respondents with a doctor who used an EHR rose from 64% to 71%. In 2011, 64% endorsed the belief that EHRs would improve healthcare quality, dropping to 62% by 2013. Simultaneously, the proportion concerned about the effects of EHRs on privacy dropped from 48% to 41%. Consumers whose doctors used EHRs were generally more likely to believe EHRs would improve healthcare quality and less concerned about privacy risks than those whose doctors did not use EHRs.
Overall, we conclude that during the early years of the MU program, exposure to EHRs increased while confidence in the benefits of EHRs and concerns about privacy risks became less marked. The subset of people exposed to EHRs via their physicians continued to have more positive attitudes toward them than those without that exposure. These attitudinal trends may be linked to increased familiarity with health information technology.