The Influence of the Degree of Rurality on EMR Adoption, by Physician Specialty

Abstract

Objective: To explore the influence of varying degrees of remoteness on practice-level electronic medical record (EMR) adoption, including whether the effect differs across practice specialty. Data Sources: Survey data on over 270,000 office-based physician practices (representing over 1,250,000 providers) collected by SK&A information services during 2012. Study Design: This study examined differences in EMR adoption by practices located across the nine-category rural–urban continuum. Logistic regressions and associated marginal effects are used to assess how much a move up or down the rural–urban continuum code impacts the likelihood of EMR adoption, after controlling for characteristics likely to affect EMR adoption such as practice size and specialty. Principal Findings: Overall practice-level EMR adoption rates generally increase with the degree of rurality and range from 47 percent in the most urban counties to over 60 percent in the most rural. Moving from the most urban county to the most rural corresponded to a 7 percent increase in the likelihood of EMR adoption (p