Volume 52 | Number 2 | April 2017

Abstract List

Brian E. Whitacre Ph.D.


To explore the influence of varying degrees of remoteness on practice‐level electronic medical record () adoption, including whether the effect differs across practice specialty.

Data Sources

Survey data on over 270,000 office‐based physician practices (representing over 1,250,000 providers) collected by &A information services during 2012.

Study Design

This study examined differences in adoption by practices located across the nine‐category rural–urban continuum. Logistic regressions and associated marginal effects are used to assess how much a move up or down the rural–urban continuum code impacts the likelihood of adoption, after controlling for characteristics likely to affect adoption such as practice size and specialty.

Principal Findings

Overall practice‐level adoption rates generally increase with the degree of rurality and range from 47 percent in the most urban counties to over 60 percent in the most rural. Moving from the most urban county to the most rural corresponded to a 7 percent increase in the likelihood of adoption ( < .01).


adoption rates do vary significantly across nonmetropolitan counties, and they generally increase as a practice becomes more rural. From a policy perspective, this suggests that practices may in fact be the lowest hanging remaining fruit for increasing adoption rates.