4 in 10 American doctors use an electronic medical record (EMR) or electronic health record (EHR), according to the Centers for Disease Control. However, most of these systems are not fully functioning.

These data come from the National Ambulatory Medical Care Survey (NAMCS) which is conducted by the National Center for Health Statistics (NCHS) in the CDC. The NAMCS measures activity in physician offices including patient visits and other aspects, including use of EMRs and EHRs.

What does it mean for an EMR/EHR to be fully “functioning?” First, a well-used system covers the basics including patient demographics, problem lists, clincal notes, Rx orders, and lab and imaging. Beyond these functions, which comprise the “basic system” which covers most of those practices that use an EMR or EHR, are the following applications: medical history and follow-up, orders for tests, Rx and test orders sent electronically, warnings of drug interactions, out-of-range test levels, and guideline reminders.

By 2009, the survey found that 43.9% of physicians reported using some or all of their EMR/EHR systems. 20.5% of doctors had systems that met the basics, and 6.3% had full functionality.

Health Populi’s Hot Points: The gap between basic and fully functioning, and between using “any” EMR/EHR — that is, the 43.9% estimate for 2009 — is essentially the obstacle course that represents the journey toward meaningful use, broadly speaking. This is clearly a marathon, not a sprint, for providers who seek to apply for a part of the $20 billion stimulus funding earmarked for EMR/EHR adoption.

It is necessary but not sufficient for EMR/EHR vendors to offer outstanding, reliable products. Those vendors who offer a high-level of service which enables providers to get to full usability will be the trusted partners in the tag-teams that get meaningful use right. Thus, it’s hardware, software and service that will blend into a recipe for success.

Don’t be fooled by the 43.9% — we’re not even close to that when we ponder a meaningful percent of providers using HIT fully. Recent publications that have dissed the productivity and impact of EMRs/EHRs in practice can point to the fact that a plethora of physicians don’t yet take full advantage of important features such as drug-drug interactions and electronic ordering for tests. When they do, they’ll get both a lovely ROI out of their investments along with providing better patient care.