U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief ■ No. 261 ■ October 2016

State Variation in Electronic Sharing of Information in 

Physician Offices: United States, 2015

Eric W. Jamoom, Ph.D., M.P.H., M.S., and Ninee Yang, Ph.D.

Key findings 

Data from the National 

Electronic Health Records 

Survey

● In 2015, the percentage

of physicians who had

electronically sent patient

health information ranged from

19.4% in Idaho to 56.3% in

Arizona.

● In 2015, the percentage

of physicians who had

electronically received patient

health information ranged

from 23.6% in Louisiana

and Mississippi to 65.5% in

Wisconsin.

● In 2015, the percentage

of physicians who had

electronically integrated patient

health information from other

providers ranged from 18.4% in

Alaska to 49.3% in Delaware.

● In 2015, the percentage

of physicians who had

electronically searched for

patient health information

ranged from 15.1% in the

District of Columbia to 61.2%

in Oregon.

The Health Information Technology for Economic and Clinical Health 

Act (HITECH) provides financial incentives to eligible providers using a 

certified electronic health record (EHR) system (1,2). In 2015, 77.9% of 

office-based physicians had a certified EHR system, up from 74.1% in 2014 

(3–5). A federal plan to enhance the nation’s health information technology 

infrastructure was published in 2015 to support information sharing (6,7). 

Therefore, this report uses the 2015 National Electronic Health Records 

Survey (NEHRS) to describe the extent to which physicians can electronically 

send, receive, integrate, and search for patient health information.

Keywords: health information technology • National Electronic Health 

Records Survey

In 2015, about one-third of physicians had electronically sent, 

received, integrated, or searched for patient health information.

Figure 1. Percentage of office-based physicians who sent, received, integrated, or searched for 

patient health information electronically: United States, 2015 

NOTE: Access data table for Figure 1 at: http://www.cdc.gov/nchs/data/databriefs/db261_table.pdf#1.

SOURCE: NCHS, National Electronic Health Records Survey, 2015.
NCHS Data Brief ■ No. 261 ■ October 2016

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● In 2015, office-based physicians had electronically sent (38.2%), received (38.3%), 

integrated (31.1%), or searched (34.0%) for patient health information from other providers 

(Figure 1).

● In 2015, only 8.7% of office-based physicians had performed all four of these activities. 

In 2015, 38.2% of physicians had electronically sent patient health 

information to other providers.

● In 2015, the percentage of physicians who had sent information electronically to other 

providers was less than the national percentage (38.2%) in Idaho (19.4%), Connecticut 

(22.7%), and New Jersey (24.3%) (Figure 2). 

● In 2015, the percentage of physicians who had sent information electronically to other 

providers was greater than the national percentage in Arizona (56.3%). 

● In 2015, the percentage of physicians who had sent patient health information electronically 

to other providers ranged from 19.4% in Idaho to 56.3% in Arizona.

 

Figure 2. Percentage of office-based physicians who sent patient health information electronically to other providers, by 

state: United States, 2015

NOTES: Significance tested at p < 0.05. Access data table for Figure 2 at: http://www.cdc.gov/nchs/data/databriefs/db261_table.pdf#2.

SOURCE: NCHS, National Electronic Health Records Survey, 2015.
NCHS Data Brief ■ No. 261 ■ October 2016

■  3  ■

In 2015, 38.3% of physicians had electronically received patient health 

information from other providers. 

● In 2015, the percentage of physicians who had received information electronically from 

other providers was less than the national percentage (38.3%) in Louisiana (23.6%), 

Mississippi (23.6%), Missouri (24.2%), and Alabama (24.3%) (Figure 3). 

● In 2015, the percentage of physicians who had received information electronically from 

other providers was greater than the national percentage in Massachusetts (52.9%), 

Minnesota (55.0%), Oregon (59.2%), and Wisconsin (65.5%). 

● In 2015, the percentage of physicians who had received patient health information 

electronically from other providers ranged from 23.6% in Louisiana and Mississippi to 

65.5% in Wisconsin.

 

Figure 3. Percentage of office-based physicians who received patient health information from other providers 

electronically: United States, 2015 

NOTES: Significance tested at p < 0.05. Access data table for Figure 3 at: http://www.cdc.gov/nchs/data/databriefs/db261_table.pdf#3.

SOURCE: NCHS, National Electronic Health Records Survey, 2015.
NCHS Data Brief ■ No. 261 ■ October 2016

■  4  ■

In 2015, 31.1% of physicians had electronically integrated patient health 

information from other providers.

● In 2015, the percentage of physicians who had electronically integrated information from 

other providers was less than the national percentage (31.1%) in Alaska (18.4%), the District 

of Columbia (18.6%), Montana (18.6%), Alabama (18.8%), and Idaho (20.6%) (Figure 4). 

● In 2015, the percentage of physicians who had electronically integrated information from 

other providers was greater in Indiana (44.2%) and Delaware (49.3%) than the national 

percentage.

● In 2015, the percentage of physicians who had electronically integrated patient health 

information from other providers ranged from 18.4% in Alaska to 49.3% in Delaware.

 

Figure 4. Percentage of office-based physicians who electronically integrated patient health information from other 

providers: United States, 2015 

NOTES: Significance tested at p < 0.05. Access data table for Figure 4 at: http://www.cdc.gov/nchs/data/databriefs/db261_table.pdf#4.

SOURCE: NCHS, National Electronic Health Records Survey, 2015.
NCHS Data Brief ■ No. 261 ■ October 2016

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In 2015, 34.0% of physicians had electronically searched for patient health 

information from other providers. 

● In 2015, the percentage of physicians who had electronically searched for information from 

other providers was less than the national percentage (34.0%) in the District of Columbia 

(15.1%), Mississippi (19.7%), Pennsylvania (20.8%), Texas (21.0%), Missouri (21.6%), and 

Oklahoma (22.8%) (Figure 5).

● In 2015, the percentage of physicians who had electronically searched for information 

from other providers was greater than the national percentage in 10 states, including Ohio 

(47.2%), Alaska (47.3%), Colorado (47.5%), Maryland (47.9%), Virginia (48.3%), North 

Carolina (48.8%), Delaware (53.9%), Wisconsin (54.1%), Washington (58.0%), and Oregon 

(61.2%).

● In 2015, the percentage of physicians who had electronically searched for patient health 

information from other providers ranged from 15.1% in the District of Columbia to 61.2% 

in Oregon.

 

Figure 5. Percentage of office-based physicians who electronically searched for patient health information from other 

providers: United States, 2015 

NOTES: Significance tested at p < 0.05. Access data table for Figure 5 at: http://www.cdc.gov/nchs/data/databriefs/db261_table.pdf#5.

SOURCE: NCHS, National Electronic Health Records Survey, 2015.
NCHS Data Brief ■ No. 261 ■ October 2016

■  6  ■

Summary

In 2015, roughly one-third of all office-based physicians had electronically sent, received, 

integrated, or searched for patient health information from other providers. About 1 in 10 

physicians had performed all four of these activities of electronic sharing of patient health 

information with other providers. 

The percentage of physicians who had electronically sent, received, integrated, or searched for 

patient health information from other providers varied by state. The percentage of physicians 

who had electronically sent patient health information to other providers ranged from 19.4% in 

Idaho to 56.3% in Arizona, while the percentage of physicians who had electronically received 

patient health information from other providers ranged from 23.6% in Louisiana and Mississippi 

to 65.5% in Wisconsin. Physicians who had electronically integrated patient health information 

from other providers also varied for office-based physicians by state, from 18.4% in Alaska to 

49.3% in Delaware. In addition, physicians who had electronically searched for patient health 

information from outside providers varied widely, from 15.1% in the District of Columbia to 

61.2% in Oregon.

This report provides information about the state of interoperability among office-based physicians 

in 2015. These four measures of electronic sharing of patient health information by physicians 

will assist in tracking the progress outlined in the federal plan for achieving interoperability 

(6,7). HITECH provides funding to states to establish an infrastructure that enables providers to 

electronically share patient health information (8). 

Definitions 

Sharing patient health information across four aspects of interoperability: The 2015 National 

Electronic Health Records Survey (NEHRS) asked physicians several questions about sending, 

receiving, integrating, and searching for patient health information electronically:

● Sending patient health information electronically: NEHRS asked physicians, “Do you 

send patient health information to other providers and public health agencies outside your 

medical organization using the following methods of data transmission?” Physicians who 

answered “yes” to either the “EHR (not eFax)” or “Web Portal (separate from EHR)” 

methods were defined as having electronically sent patient health information.

● Receiving patient health information electronically: NEHRS asked physicians, “Do you 

receive patient health information from other providers and public health agencies outside 

your medical organization using the following methods of data transmission?” Physicians 

who answered “yes” to either the “EHR (not eFax)” or “Web Portal (separate from EHR)” 

methods were defined as having electronically received patient health information.

● Integrating patient health information electronically: NEHRS asked physicians, “When 

electronically receiving information from other providers, are you able to integrate the 

following types of patient health information into your EHR without special effort like 

manual entry or scanning?” The 10 different types of patient health information included: 

medication lists, patient problem lists, medication and allergy lists, imaging reports, 

laboratory results, registry data, referrals, hospital discharge summaries, emergency 
NCHS Data Brief ■ No. 261 ■ October 2016

■  7  ■

department notifications, and summary-of-care records for transitions of care or referrals. 

Physicians who answered “yes” to at least one of the 10 different types of patient health 

information were defined as having electronically integrated patient health information.

● Searching patient health information electronically: NEHRS asked physicians, “How often 

do you electronically search for health information from sources outside of your medical 

organization when seeing a new patient or an existing patient who has received services 

from other providers?” Physicians who answered “always,” “often,” or “sometimes” were 

defined as having electronically searched for patient health information.

Data source and methods

Statistics are presented on data collected in the 2015 NEHRS. The NEHRS, which is conducted 

by the National Center for Health Statistics and sponsored by the Office of the National 

Coordinator for Health Information Technology, is a nationally representative mixed-mode survey 

of office-based physicians that collects information on physician and practice characteristics, 

including the adoption and use of EHR systems. NEHRS sampling design allows for both 

national and state-based estimates of EHR adoption. NEHRS is conducted annually as a 

sample survey of nonfederal office-based patient care physicians, excluding anesthesiologists, 

radiologists, and pathologists. 

The 2015 NEHRS estimates include a sample of 10,302 physicians, which is designed to produce 

national and state-based estimates of office-based physicians. The 2015 NEHRS data collection 

took place from August through December 2015, and it used a sequential mixed-mode design to 

collect data through web, mail, and phone (4). 

The overall unweighted response rate of the 2015 NEHRS questionnaire was 51.9% (49.2% 

weighted). A copy of the 2015 NEHRS questionnaire is available from the NCHS website at: 

http://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm. 

Statements of differences in estimates are based on statistical tests with significance at the 

p < 0.05 level. All differences are statistically significant unless stated otherwise. Data analyses 

were performed using the statistical package Stata version 14.0 (StataCorp LP, College Station, TX).

About the authors 

Eric W. Jamoom and Ninee Yang are with the National Center for Health Statistics, Division of 

Health Care Statistics, Ambulatory and Hospital Care Statistics Branch.

References

1. Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health records. 

N Engl J Med 363(6):501–4. 2010.

2. Centers for Medicare & Medicaid Services. Electronic Health Records (EHR) Incentive 

Programs. Baltimore, MD. Available from: https://www.cms.gov/ehrincentiveprograms/. 

3. Jamoom EW, Yang N, Hing E. Adoption of certified electronic health record systems and 

electronic information sharing in physician offices: United States, 2013 and 2014. NCHS data 
NCHS Data Brief ■ No. 261 ■ October 2016

brief, no 236. Hyattsville, MD: National Center for Health Statistics. 2016. 

Available from: http://www.cdc.gov/nchs/products/databriefs/db236.htm.

4. Jamoom EW, Yang N, Hing E. Percentage of office-based physicians 

using any electronic health records or electronic medical records, physicians 

that have a basic system, and physicians that have a certified system, by state: 

United States, 2014. 2015. Available from: http://www.cdc.gov/nchs/data/

ahcd/nehrs/2015_web_tables.pdf.

5. Jamoom EW, Yang N. Table of electronic health record adoption and use 

among office-based physicians in the U.S., by state: 2015 National Electronic 

Health Records Survey. 2016. Available from: http://www.cdc.gov/nchs/data/

ahcd/nehrs/2015_nehrs_web_table.pdf.

6. The Office of the National Coordinator for Health Information 

Technology. Connecting health and care for the nation: A shared nationwide 

interoperability roadmap Version 1.0. 2015. Available from: 

https://www.healthit.gov/sites/default/files/hie-interoperability/nationwideinteroperability-roadmap-final-version-1.0.pdf.

7. The Office of the National Coordinator for Health Information 

Technology. Federal health IT strategic plan: 2015–2020. 2015. Available 

from: http://dashboard.healthit.gov/strategic-plan/federal-health-it-strategicplan-2015-2020.php. 

8. Williams C, Mostashari F, Mertz K, Hogin E, Atwal P. From the Office 

of the National Coordinator: The strategy for advancing the exchange of 

health information. Health Aff (Millwood) 31(3):527–536. 2012.

Suggested citation

Jamoom EW, Yang N. State variation 

in electronic sharing of information in 

physician offices: United States, 2015. 

NCHS data brief, no 261. Hyattsville, MD: 

National Center for Health Statistics. 2016.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Denys T. Lau, Ph.D., Acting Director

Alexander Strashny, Ph.D., Associate 

Director for Science

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