By JACOB GOLDSTEIN

Only 9% of U.S. hospitals have electronic health records, according to a new survey that reveals the gap between the present state of American health care and a high-tech future envisioned by policy makers.

“We are at a very early stage in adoption, a very low stage compared to other countries,” said David Blumenthal, a Harvard professor and an author of the survey. Last week, the Obama administration named Dr. Blumenthal National Coordinator for Health Information Technology.

The survey, sent to hospitals in March 2008 and published online Wednesday by the New England Journal of Medicine, found that most institutions have some basic electronic systems, such as those for reporting patients’ lab results.

The electronic-record systems advocated by President Barack Obama and former President George W. Bush go further, however, often replacing paper records and including doctors’ notes, treatment orders and automatic safety alerts.

Cost was the most commonly mentioned barrier to adoption of such systems, cited in the survey by 74% of hospitals without electronic records. That suggests many facilities are likely to tap into federal incentives aimed at increasing the use of electronic records.

The economic-stimulus package that Congress passed in February is likely to generate more than $20 billion in federal outlays for health-information technology, mostly between 2011 and 2015, according to the Congressional Budget Office.

Costs for installing electronic records systems vary widely, but a midsize hospital might spend about $10 million over several years, said Erica Drazen, who runs the research group for the health-care division at Computer Sciences Corp. The stimulus incentives are likely to cover much, but not all, of the cost — $6 million to $7 million for a midsize hospital, Ms. Drazen said.

Only 1.5% of hospitals have adopted what the survey’s authors define as a comprehensive, hospital-wide system. Another 7.6% of hospitals have adopted basic systems in at least one unit of the hospital, according to a less-rigorous definition that includes electronic physician notes, but not certain other features.

Proponents of electronic records say they will improve patient safety, reduce unnecessary testing and create useful data to measure quality of care. But the push is controversial, as skeptics point to the cost and complexity of installing the systems and building data networks required to share information electronically between doctors’ offices and hospitals. Some doctors argue that the systems are a distraction that takes away from patient care; more than a third of the hospitals that hadn’t adopted electronic records cited resistance from physicians as one reason.

The survey, based on responses from more than 2,900 U.S. hospitals, was funded by the federal government and the Robert Wood Johnson Foundation. The study excluded federal hospitals, such as those for veterans.

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