[Skip to Content]
[Skip to Content Landing]
Original Investigation
February 2018

Adoption of Electronic Health Records and Perceptions of Financial and Clinical Outcomes Among Ophthalmologists in the United States

Author Affiliations
  • 1Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento
  • 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Division of Health Sciences Informatics, Johns Hopkins University, School of Medicine Baltimore, Maryland
  • 4Web Editor, JAMA Ophthalmology
  • 5Stein Eye Institute, University of California Los Angeles
  • 6California Cornea Consultants, Escondido
  • 7Departments of Ophthalmology and Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland
  • 8Children’s Eye Care, Kirkland, Washington
  • 9American Academy of Ophthalmology, San Francisco, California
JAMA Ophthalmol. 2018;136(2):164-170. doi:10.1001/jamaophthalmol.2017.5978
Key Points

Question  What is the current electronic health record (EHR) adoption rate among ophthalmologists in the United States, and what is their perception of financial and clinical productivity following implementation?

Findings  In this population-based, cross-sectional survey, the adoption rate of EHRs among ophthalmologists was 72.1%. Ophthalmologists reported that their net revenues and productivity have declined and that practice costs are higher with EHR use.

Meaning  The EHR adoption rate has doubled since a previous EHR survey of American ophthalmologists in 2011, and in comparison with 2 previous EHR surveys, perceptions of practice costs and clinical productivity are more negative.


Importance  Assessing the rate of electronic health record (EHR) adoption and ophthalmologists’ perceptions on financial and clinical productivity is important in understanding how to direct future design and health care policy.

Objective  To assess adoption rate and perceptions of financial and clinical outcomes of EHRs among ophthalmologists in the United States.

Design, Setting, and Participants  Population-based, cross-sectional study. A random sample of 2000 ophthalmologists was generated on the basis of mailing address zip codes from the 2015 American Academy of Ophthalmology US active membership database, which included more than 18 000 ophthalmologists. A survey was sent by email to assess adoption rate of EHRs, perceptions of financial and clinical productivity, and engagement with Medicare and Medicaid programs that incentivize the use of EHRs. The survey was conducted between 2015 and 2016.

Main Outcomes and Measures  Adoption rate of EHRs and perceptions of financial and clinical productivity.

Results  The adoption rate of EHRs among surveyed ophthalmologists (348 respondents) was 72.1%. The responding ophthalmologists perceived that their net revenues and productivity have declined and that practice costs are higher with EHR use. Of those who attested for stage 1 of the EHR incentive program, 83% had already or were planning to attest to stage 2, but 9% had no plans.

Conclusions and Relevance  The adoption of EHRs by ophthalmologists has more than doubled since a 2011 survey and is similar to that of primary care physicians (79%). In comparison with 2 previous surveys of ophthalmologists, respondents had more negative perceptions of EHR productivity outcomes and effect on practice costs, although financial data were not collected in this survey to support these opinions. These negative perceptions suggest that more attention should be placed on improving the efficiency and usability of EHR systems.