Assessing the limitations of the existing physician directory for measuring electronic health record (EHR) adoption rates among physicians in Connecticut, USA: cross-sectional study

OBJECTIVE: To assess the limitations of the existing physician directory in measuring electronic health record adoption rates among a cohort of Connecticut physicians. DESIGN: A population-based mailing assessed the number of physicians practising in Connecticut. MEASUREMENTS: Information about practice site, practises pertaining to storing of patient information, sources of revenue and preferred method for receiving survey. Practice status in Connecticut, measured by yes and no. Demographic information was collected on gender, year of birth, race and ethnicity. RESULTS: The response rate for the postcard mailing was 19% (3105/16 462). Of the 16 462 unduplicated consumers, 233 (1%) were retired and 5828 (35%) did not practise in Connecticut. Of the 3105 valid postcard responses we received, 2159 were for physicians practising in Connecticut. Nine (0.4%) of these responses did not specify a preferred method for receiving the full physician survey; 91 physicians refused to participate in the survey; 2159 surveys were sent out using each physician's requested method for receiving the survey, that is, web-based, regular mail or telephone. As of August 2012, 898 physicians had returned surveys, resulting in a response rate of 42%. LIMITATIONS: The postcard response rate based on the unduplicated lists adjusted for exclusions, such as death, retired and do not practise in Connecticut, is 30%, which is low. We may be missing physicians’ population which could greatly affect the indicators being used to measure change in electronic health record adoption rates. CONCLUSIONS: It is difficult to obtain an accurate physician count of practising physicians in Connecticut from the existing lists. States that are participating in the projects funded under various Office of the National Coordinator for Health Information Technology (ONC) initiatives must focus on getting an accurate count of the physicians practising in their state, since their progress is being measured based on this key number.