A tiny percentage U.S. hospitals use e-health records, according to a new survey by a team that includes the incoming national coordinator for health information technology.

Fewer than 8 percent of hospitals have EHRs in even one clinical department, and only 1.5 percent have EHRs for all clinical departments, the researchers reported in today's online edition of the New England Journal of Medicine.

Lead author Ashish Jha, a physician and associate professor at the Harvard School of Public Health, called the adoption levels in hospitals "abysmally low. We have a long way to go to achieve a health care system that is fully electronic."

Earlier studies found EHR adoption rates of between 5 percent and 59 percent, the report states. However, researcher Catherine DesRoches, an assistant at the Institute for Health Policy of Massachusetts General Hospital, said those earlier studies generally had nonrepresentative samples or low response rates.

Working with the Association of American Hospitals, Jha's team surveyed nearly 3,000 hospitals. Its numbers excluded the highly automated hospitals of the Veterans Affairs Department . If it had included VA hospitals, the EHR adoption rates would be about twice as high, Jha said.

The hospitals in the survey said the cost of the systems was the biggest reason they had not implemented EHRs. John Glaser, vice president and chief information officer of Partners HealthCare System, predicted that the financial incentives in the recently enacted economic stimulus law will spur adoption. "I'm encouraged by the legislative stuff," he said.

In addition to Jha, Glaser and DesRoches, the research team included Dr. David Blumenthal, newly appointed national coordinator for health IT. Blumenthal spoke at a press conference about the research but refused to talk about his new job.

"The data collectively show that we are at a very early stage of adoption," Blumenthal said, calling that situation "a great opportunity." The stimulus law could enable small hospitals that implement EHRs to recoup all their costs, he said.

The law not only gives hospitals financial incentives for EHR adoption, but also provides for technical assistance with selection and implementation of the systems. It also funds efforts to enable systems from various vendors to exchange information. The study found that hospitals would welcome all those strategies.

Although larger teaching hospitals in urban areas are more likely to have EHRs, there were few other major distinctions between adopters and nonadopters, the researchers said. For example, public and private hospitals were about even in the study.

The study used an expert panel to define EHRs and establish what minimum levels of functionality should be present before a hospital could be said to be using EHRs. The data was collected in 2008.

The Robert Wood Johnson Foundation and the Office of the National Coordinator for Health IT paid for the study.