Patient records are digital

Grader A: partial

In 2009, 48.3% of US office physicians used some electronic records, but only 21.8% had a basic system, and records were fragmented, not lifetime. The HITECH Act (2009) then pushed adoption, which became mainstream in the early 2010s. Lifetime, integrated records remained rare.

Test: Office physicians with a basic EHR: 21.8% in 2009 (any EMR 48.3%). Lifetime longitudinal records: well under 20% of patients.

• Electronic Medical Record/Electronic Health Record Use by Office-based Physicians: 2009 (CDC NCHS) (2009-12): 48.3% any EMR/EHR; 21.8% basic system (2009).
• HITECH Act (Wikipedia) (2026-09-28): 2009 law committed $25.9bn and incentive payments to spur EHR adoption.

Grader B: hit

Computerized patient records reached the mainstream among US office physicians by 2011: 57% used some EMR/EHR system and 34% had a basic system, up from 17% (basic or full) in 2008. Truly lifetime, cradle-to-grave records were rare outside integrated systems such as the VA and Kaiser; records stayed fragmented across providers. Under the rule's dominant reading (patient records kept in computer databases), the threshold was met by 2011.

Test: Mainstream test: 20% of the relevant industry routinely uses the practice. 2008: 17% of office physicians with basic or full EHR. 2011: 57% any EMR/EHR, 34% basic (NCHS).

• EHR adoption among office-based physicians, 2011 (NCHS Data Brief 79) (2011-11): 57% of office-based physicians used any EMR/EHR in 2011 (51% in 2010); 34% had a basic system (25% in 2010).
• Electronic health records in ambulatory care (DesRoches et al., NEJM) (2008-07-03): 2008: 4% fully functional and 13% basic EHR.