U.S. hospitals making only modest gains in adoption of EHRs

Aug. 27, 2010

Boston, MA – Transforming the U.S. health care system from paper based to electronic based may improve health care quality and reduce costs, but a new study by researchers from the Harvard School of Public Health (HSPH) suggests that goal is far off. The adoption of basic or comprehensive electronic health records (EHR) by U.S. hospitals increased modestly from 8.7 percent in 2008 to 11.9 percent in 2009, but only 2 percent of hospitals met the federal “meaningful use” standard needed to qualify for government financial incentives.

The researchers also found that smaller, rural, and public hospitals fell further behind their larger, private and urban counterparts in adopting EHRs, further widening the gap between the two groups in receiving the benefits of health information technology.

The study appears August 26, 2010, in an advance online edition of Health Affairs.

The researchers drew from a survey by the American Hospital Association, which asked 4,493 acute-care non-federal hospitals about their health information technology efforts as of March 1, 2009; 3,101 (69 percent) responded. A representative from each hospital reported on the presence or absence of 32 clinical functions of an EHR and how widely they had been implemented throughout the hospital. Responses were statistically adjusted to balance for hospitals that did not respond.

They found that hospitals’ adoption of basic or comprehensive EHR systems increased by 3.2 percent between 2008 and 2009. Based on the measures examined by the authors, only approximately 2 percent of U.S. hospitals described EHRs that would allow them to meet the criteria in the American Recovery and Reinvestment Act for “meaningful use,” which doctors and hospitals must meet by 2012 in order to receive financial incentives through Medicare and Medicaid reimbursements. These meaningful use guidelines include 14 core functions, such as prescribing electronically and keeping an active medication list for patients.

Given the state of the economy at the time the survey was conducted, Jha is not surprised that adoption rates for EHR systems, which can cost tens of millions of dollars to purchase and implement, remain low. He notes that the government’s financial incentives may go primarily to larger, academic hospitals, further widening an already large digital divide.

SOURCE: Harvard School of Public Health

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