Systems defined as "basic" include the following functionalities: patient demographic information, patient problem lists, clinical notes, prescription ordering, and laboratory and imaging results viewing.
Systems defined as "fully functional" include all functionalities of basic systems plus the following: medical history and follow-up, orders for tests, prescription and test orders sent electronically, warnings of drug interactions or contraindications, highlighting of out-of-range test levels, and reminders for guideline-based interventions.
In 2008, about 16.7% of physicians reported having systems that met the criteria of a basic system, and about 4.4% reported that of a fully functional system, according to the CDC report.
According to preliminary estimates from the 2009 mail survey, about 20.5% of physicians reported having systems that met the criteria of a basic system, and 6.3% reported that of a fully functional system.
Comparable figures for basic and fully functional systems in the 2007 NAMCS were 11.8% and 3.8%, respectively.
Some physicians reported their systems having functionality that did not appear on the surveys' list of choices, while other doctors did not know the functionality of their practices' EMR or EHR systems. Those doctors were not considered to be using basic or fully functional systems in the CDC findings.
"Some of these systems are older and were tailored to meet specific needs of a practice, some were off-the-shelf systems, and some doctors reported having new systems they haven't used yet," said Hing. "There are a lot of variants in the systems that have been on the market," she said.
Efforts by the U.S. government's Office of National Coordinator for Health IT to develop EMR/EHR standards and certification criteria over recent years -- and most recently as part of the ARRA's stimulus programs -- will help to get more U.S. doctors using interoperable systems with lists of functionality that can help achieve meaningful use guidelines being set, Hing said.