EHR Adoption on the Rise, Meeting MU Stage 2 Still a Challenge in Hospitals

Aug. 14, 2014
The number of hospitals that have adopted a basic or comprehensive electronic health record (EHR) system has climbed steadily since 2010 but few providers can meet all of the Stage 2 meaningful use criteria, a new research study found.

The number of hospitals that have adopted a basic or comprehensive electronic health record (EHR) system has climbed steadily since 2010 but few providers can meet all of the Stage 2 meaningful use criteria, a new research study found.

The study, published in a recent issue of Health Affairs, looked at adoption of EHR systems in hospitals since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH). Researchers, led by Julia Adler-Milstein, Ph.D., University of Michigan School of Public Health assistant professor of information, examined the 2013 American Hospital Association (AHA) Annual Survey of Hospitals–IT supplement.

What they found was that while 58.9 percent of hospitals had adopted a basic or comprehensive EHR, quadruple the percentage in 2010, only 5.8 percent met the criteria for Stage 2 meaningful-use readiness.

The researchers note, however, that most hospitals say they are able to meet many stage 2 objectives, just not all of them. Approximately 90 percent of hospitals can use their EHR to record vital signs, smoking status, and patient demographic characteristics. A similar large amount of hospitals can track medications through an electronic medication administration record (eMAR). On the low end, only 10 percent have met the patient view, download, and transmit criteria and a similarly low number were able to provide summary of care records for transitions.

“Despite the substantial increase in EHR adoption, meeting Stage 2 meaningful-use objectives will require work for the vast majority of hospitals. Our findings suggest that functions related to electronic data exchange, both with other providers and with patients (in particular, providing summaries of care during transitions and giving patients the ability to view online, download, and transmit their health information) are critical gaps,” the authors note.

One of the surprising findings was that the gap in EHR adoption between hospitals that serve poor patients and those with better-resources has yet to materialize. The digital divide doesn’t truly exist, however, rural and smaller hospitals are falling behind in adoption. Most of those institutions that had yet to adopt a basic EHR were small, for-profit, rural, and critical-access institutions.

“The remaining gap in EHR adoption between small, rural, and critical-access hospitals and other institutions suggests that the efforts by Regional Extension Centers, although clearly helpful, may not be enough. The centers may simply not have enough capacity to assist all of the hospitals that need help,” the authors write.

The Office of the National Coordinator for Health IT (ONC) used the findings of the study, as well as another Health Affairs study on physician adoption, to promote the success of the meaningful use program.

“Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” Karen DeSalvo, M.D., M.P.H., national coordinator for health information technology, said in a statement. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.”

ONC did note the challenges that lay ahead in getting hospitals and other providers to attest to Stage 2 in its press release.

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