Background: The United States is modernizing the information technology infrastructure of its health care system. The provisions of the American Recovery and Reinvestment Act that are known as the Health Information Technology for Economic and Clinical Health (HITECH) Act provide substantial economic incentives for physicians to implement and use electronic health records (EHRs) (1, 2). Since the passage of the HITECH Act, studies have consistently found EHR use increasing steadily among office-based physicians (3, 4). However, recent studies report that a substantial proportion of physicians are unsure about or are not planning to participate in the program (5). Understanding which ...


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