"Ultimately, what I hear doctors saying is, 'Let me get this straight. You want me to spend money to put in a system that will be harder to use and slow me down, so I will earn less money, and that the end result is that someone else makes more money," Handler said. "If you phrase it that way, it's not illogical to see why they don't want to do it."
E-prescribing is another example. "Docs say, 'I didn't go to medical school to become a data entry clerk so Walgreens could hire one less pharmacy tech to enter the system.'"
Handler said current meaningful use criteria also doesn't take aim with incentives that address what physicians consider some of the most critical reforms needed in healthcare today.
For example, Handler said, a computer-based patient record system can catch duplicate patient test orders, but the current meaningful use incentives don't penalize physicians for ordering duplicate tests.
Ultimately, it's the patient -- the insurance company and then society -- that pays for the duplicate test, and yet, its the physician who'll have to foot the cost for the system that can prevent the duplicate tests, he said.
Dr. Harry Greenspun, chief medical information officer for Dell and a member of the Healthcare Information and Management Systems Society (HIMMSS), said resistance to EHR adoption can be as simple as a physician not wanting to add steps to a process that has worked for decades.
"It's really easy to write a prescription; you just jot it down on note paper. On a computer screen it can take a lot longer," he said. "If you go have to through a check list or a menu-driven program, it can be clunky, and a barrier to adoption."
"On the other hand," he continued, "If I can share [radiological] images, pull data from other systems, write a prescription all from one screen ... and get valid prescription alerts and find out about public health threats, then the value is obvious."
The CDC said there has been an increasing trend in EHR use among office-based physicians from 2001 - when the first survey was conducted -- through the preliminary 2010 survey estimates.
Combined data from the surveys taken in 2009, for example (both mail survey and in-person surveys), showed that 48.3% of physicians reported using all or partial EHR systems in their office-based practices.
About 21.8% of physicians reported having systems that met the criteria of a basic system, and about 6.9% reported having systems that met the criteria of a fully functional system, a subset of a basic system.