The ASC industry trails much of the inpatient world when it comes to electronic medical records.
According to the Ambulatory Surgery Center Association’s July 2025 survey, 76% of ASCs now use an EHR, up from 55% in 2021. Yet nearly 1 in 4 ASCs still rely on paper, and two-thirds of those organizations plan to remain paper-based until regulations force a change. For the first time since 2021, the ASCA’s survey found data collection ranked as the most valuable EHR benefit, cited by 87% of users.
Cost is the top barrier, with 49% of survey participants citing expense as the reason for staying analog. Some ASC leaders said they also struggle to find EHRs that can be easily integrated into outpatient workflows, with many systems designed specifically for hospitals and health systems.
Jeffrey Carlson, MD, president of Newport News, Va.-based Orthopaedic & Spine Center, recently joined Becker’s to discuss what ASCs need from EHRs and what makes them truly beneficial for outpatient facilities.
Note: This response has been lightly edited for style and clarity.
Question: From an ASC leader’s perspective, what does true EHR interoperability look like, and where are the biggest gaps today?
Dr. Jeffrey Carlson: EHR interoperability between ASC, hospital and physicians office has a long way to go. Coordinating care should be seamless between agreeable parties. All too often hospital owned ASCs will want to have every physician office use the hospital-owned EHR. Unfortunately, hospital EHRs are too cumbersome for ASC efficiency and too expensive for physician offices. For surgeons to place patients on the operative schedule, it may require entering three EHRs with different passwords and different hard stops programmed into their system. This is time consuming and may lead to more errors. Certainly not the sleek experience we want to have at an ASC.
