U.S. Hospitals Making Only Modest Gains in Adoption of Electronic Health Records

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) in Boston, Mass. 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 researchers drew from a survey by the Chicago-based 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.