Using Electronic Prescribing Transaction Data to Estimate Electronic Health Record Adoption

Objective: To determine whether electronic prescribing transaction data can be used to accurately and efficiently track national and regional electronic health record (EHR) adoption in order to evaluate progress toward national goals and identify and address regional disparities. Study Design: This study compared national EHR use estimates derived from Surescripts electronic prescribing data for 2007 and 2008 with contemporary National Ambulatory Medical Care Survey (NAMCS) estimates. Methods: The ratio of relative risks was adapted to test the statistical significance of the difference in the differences between Surescripts and NAMCS estimates in 2007 and 2008. Results: In 2007, the relative ratio (RR) of NAMCS to Surescripts data was 3.73 (95% confidence interval [CI] = 3.27, 4.26). In 2008, the RR was 2.06 (95% CI = 1.75, 2.42). The ratio of RRs for 2007 compared with 2008 was 1.81 (P < .0001), suggesting that Surescripts transactional data for providers prescribing through an EHR is becoming better aligned with accepted measures of EHR adoption in the United States with time. Surescripts-derived state estimates for EHR use ranged from less than 8% (North Dakota, New Jersey, New Mexico) to more than 37% (Minnesota, Wisconsin, Massachusetts, Iowa). Conclusions: Surescripts transactional data may allow for the ongoing identification of regional trends and assist policy makers in identifying and mitigating emerging disparities in EHR adoption. Further analysis is needed to ensure that Surescripts data continue to correlate with NAMCS results for 2009-2010. (Am J Manag Care. 2010; 16(12 Spec No): e320-e326)