Primary Care Physicians' Use of Electronic Health Records in Rhode Island: 2009-2014.

We used data from the mandatory statewide Rhode Island (RI) Health Information Technology (HIT) Survey to characterize office-based PCPs' adoption and use of EHRs from 2009-2014. We found accelerated adoption of EHRs in the five years since state and federal incentive programs began targeting PCPs' adoption of HIT. There was room for improvement, however; for example, when asked to indicate the proportion of patients with whom they used various functionalities, only 13.4% of office-based PCPs said they "almost always" communicated with patients using secure messaging and 22.3% "almost always" used secure clinical messaging with outside providers. Results suggest uneven use of EHR functionalities, with low rates and slower uptake in some areas. These findings highlight opportunities to increase use of functionalities related to improved patient care and quality-based payment models.