Ohio Electronic Health Records Survey: Increasing Response Rates Surveying Medical Practices
*Daniel Weston II, The Ohio Colleges of Medicine 

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To determine electronic health record (EHR) use rates and adoption rates for Ohio’s medical practices, Ohio State University conducted a mixed-mode sample of 4,843 Ohio medical practices (primary care physicians, dentists, pediatricians, medical specialists, and nurse practitioners/nurse midwives). A sample was obtained using Medicaid’s 2010 provider list and the National Provider Identifier Registry for Ohio-specific practices. The EHRS utilized a staged process of postcard notification, e-mail notification, mailing of the instrument for completion requesting either a return mail or fax response, follow-up postcard and two follow-up e-mails, with the option of an additional instrument delivery by either e-mail or postage. The survey’s main purposes were to determine EHR uptake, barriers to EHR adoption, and the likelihood of EHR adoption. The fielding period was scheduled for 6 weeks. After 3-weeks, only 6.4% of potential respondents returned a completed instrument. With a target return rate of at least 20%, the research team adjusted the contact protocol and initiated a telephone calling campaign to urge practices to complete and return the survey. Options given by callers for completion included: (1) phone interviews with the caller, (2) return by fax, (3) return by e-mail, and (4) return by postage. To encourage response, a blanket approach was employed by faxing all non-responding medical practices the a cover letter and instrument, followed by phone contact. The result was a 19.3% response rate. To factor for the mixed-mode, a judgement poststratification estimator for proportion of having an EHR was employed. The mixed-mode collection was most effective for specialists, primary care physicians, and dentists, and least effective for nurse practitioners/nurse midwives. The conclusion is medical professionals are more likely to respond to multiple contact modes that include a blanketing approach and that faxing medical providers was more effective than electronic communications or postage.