Physician adoption of electronic health records: a visualisation of the role of provider and state characteristics in incentive program participation

Introduction. To encourage electronic health record adoption, in 2011, the Centers for Medicare & Medicaid Services created programmes that offer providers financial incentives for adopting the electronic health record. The objective of the study was to analyse the role of provider and state characteristics in provider time of adoption of the electronic health record. Method. The Centers for Medicare & Medicaid public use file of payments to providers were merged with publicly available databases consisting of the provider's specialty and the characteristics of the state within which the provider practices. Publicly available provider age data formed a subset in our database. We produced visual analytics in Tableau, a visualisation software, to represent the impact of provider and state characteristics. Results. Family medicine physicians and internists were the most active in adoption. Providers in their forties and fifties were earlier in adoption of the electronic health record. Later adopters were in states with higher chronic disease rate (that is, three out of four chronic disease rates studied) and higher minority populations. Conclusions. Regional Extension Centers are instrumental in supporting providers in their adoption of health information technology. Using better strategies for timing and diffusing new health information technology to underprivileged areas can improve health care and reduce inequities in patient care.