Adoption of advanced health IT capabilities—such as predictive analytic functions and patient access to records—varies among U.S. healthcare organizations, but health systems that standardize their EHRs (electronic health records) and that own and manage hospitals and medical groups have higher rates of advanced health IT adoption and use, according to new research.
The research, published recently in the American Journal of Managed Care, set out to identify characteristics that may drive the advanced health IT adoption variability among health systems.
Researchers looked at responses from the 2017/2018 National Survey of Healthcare Organizations and Systems to assess the extent to which healthcare system organizational structure, EHR standardization, and resource allocation practices were associated with use of five advanced health IT capabilities: patients’ access to their EHRs; patients’ ability to electronically comment on their medical records; physicians’ and patients’ ability to communicate with each other via secure email; physicians’ ability to know whether patients have filled prescriptions; and advanced analytics capabilities.
After eliminating systems that did not have fully adopted basic EHRs, 389 healthcare systems were included in the study. One of the study’s key findings was that EHR standardization was the strongest predictor of advanced HIT adoption. Owning and managing medical groups and hospitals was also a statistically significant predictor of advanced HIT adoption.
For each of the five advanced health IT capabilities outlined, respondents were asked how many hospitals or medical groups in their systems had the following features, with possible answers being “none,” “some,” “most,” or “all.” Researchers assigned one point to answers of “most” or “all” and 0 points to answers of “none” or “some.” Overall adoption was then measured on a scale of 0 to 5, with a score of 0 indicating no capabilities had been adopted successfully and a score of 5 indicating all capabilities were adopted successfully.
The results showed that the adoption of advanced health IT capabilities was inconsistent. What’s more, only 8 percent of systems in the sample reported adopting all five advanced health IT capabilities. Adoption rates also varied widely by feature, with more than 75 percent of systems reporting the ability of patients to access their medical records but less than 32 percent reporting the ability of physicians to know when patients fill prescriptions and of patients to comment on their medical records.
Just under half (49 percent) of the responding systems owned and managed their hospitals and medical groups. Most systems used a single EHR (69 percent) and standardized EHR data elements (59 percent), although just under half reported using both a single EHR and standardized data elements (48 percent).
APM (alternative payment model) experience varied, with the lowest rate of participation being in risk-bearing ACOs (22 percent) and the highest rate of participation being in primary care improvement and pay-for-performance programs (60 percent).
The authors concluded, “The degree of EHR standardization within health systems, as measured by the degree of uniformity of technology systems and data elements across hospitals and medical groups, is a stronger predictor of advanced health IT adoption than the system’s ownership and management structure, resource allocation practices, or APM participation. Health system leaders looking to improve the diffusion of new technologies should consider ways to better standardize their implementation and use of EHRs to drive widespread adoption of and benefit from new features.”
