Electronic Health Records (EHR) have been around for several decades, yet most of the focus on nationwide adoption has occurred since President Bush’s Executive Order in 2004 which directed that all Americans should have access to an EHR by the year 2014. Given the complexity of EHRs, the multitude of different settings, uses and infrastructure—it is not surprising that measuring adoption rates is a challenge. 

Several different sources are available and they all provide an estimate for how many physicians and health care facilities have implemented an EHR.  Complexities abound in how this should be measured: are functionalities (what functions the system performs) still used? By what percentage of total users? and what impact on patient care. 

The Office of the National Coordinator of Health Information Technology (ONC) provides perhaps the quickest insight to several studies:  Most estimates for physician implementations still hover near 17 percent of practices.  The results of these surveys are based upon the descriptions of two levels of adoption: basic and full.

The Health Information Management and Systems Society (HIMSS) also has an EMR Adoption Model, which registers adoption rates depending upon different stages of functionality.

Either way, adoption of health information technology is moving slowly. The HITECH Act has served to “light a fire” under the process.  Now is a critical time for dietitians to become involved in the process by volunteering for EHR Adoption Committees, working with EHR vendors to assure that the Nutrition Care Process and Model and the International Dietetics and Nutrition Terminology is included in how we deliver nutrition care.  These resources, amongst others will provide the necessary framework for designing nutrition care in EHRs—and consistency across providers will allow for nutrition notes and consults to be an expectation of exchanging data.