Int J Emerg Med (2010) 3:181–185 had adopted. We accomplished this by creating a comput- erization score, as was done in a prior study [5]. This score is simply a count of applications, with one point assigned for each acquired application. We then used multiple linear regression to predict computerization score by the above ED characteristics and planned to consider any character- istic to be a “significant” predictor of the computerization score if the p-value of its beta coefficient was ≤ 0.05. We used the SAS spec option to assess for heteroscedasticity and inspected residual plots for qualitative evidence of a relationship. Results Of 69 EDs surveyed, 68 (99%) in 23 US states completed the survey. Table 1 shows the characteristics of EDs surveyed. The participants were generally large urban academic EDs, with 44% located in the Northeast. Table 2 shows the number and proportion of EDs reporting availability of selected health information tech- nologies. Computerized physician order entry, clinical decision support, and bar coding technology were present in fewer than 40% of EDs. In contrast, some other applications were present in most of the EDs surveyed, including laboratory test ordering and results, notes from prior encounters, and ECG results. The right-hand column of Table 1 shows the computerization score (see Methods), stratified by ED characteristics. Our analysis of ED characteristics did not reveal any significant variation in availability of electronic medication ordering or computerization score, by emergency medicine residency affiliation, annual census, or region. Table 2 Information technology in 68 US emergency departments 183 Discussion Information technology is ubiquitous in our society. Businesses from restaurants to banks and airlines rely on such technology to process information that has much in common with medical information. Such technology has been recommended strongly for health care settings [1]. Why, then, would our nationwide sample of EDs reveal that only 19% have the capability to check a medication order to see if the patient has a documented allergy to that medication? Reasons might include apprehension. In the enthusiasm to promulgate the spread of health information technology, the downsides are often under-emphasized [6]. Moreover, purchase and implementation of such technology is not necessarily cost-effective [7]. The present report echoes the findings of the three prior studies of health information technology adoption in US EDs—namely, slow uptake of certain applications [2, 3]. Only two of these prior studies assessed the adoption of individual applications, such as computerized physician order entry. One was a survey of US emergency medicine residency-affiliated EDs in 2000, and the second was a survey of all Massachusetts EDs in 2006 [2]. Our ability to conduct direct quantitative comparisons across time is limited, because different EDs participated in the surveys. However, certain qualitative observations seem valid. All three studies revealed that a minority of EDs had computerized medication ordering: 38% in the present national study, 15% in the 2006 MA study, and 18% in the 2000 national study. Quantitatively, the increase from 18% to 38% might indicate wider dissemination of these technologies, or might be due to sampling variation. Information technology application Computerized physician medication order entry Clinical decision support for medication allergies Clinical decision support for drug-drug interactions Outpatient notes Inpatient notes Surgical notes Prior ED visit notes Laboratory results Laboratory test ordering Test ordering other than laboratory tests Radiology results EKG results Patient tracking Bar coding for patient, medication, or sample identification Number (%) of EDs reporting availability of each application 26 (38%) 13 (19%) 9 (13%) 39 (57%) 43 (63%) 53 (78%) 54 (79%) 66 (97%) 39 (57%) 42 (62%) 67 (99%) 62 (92%) 50 (74%) 14 (20%)