As EHR adoption spikes, Meaningful Use Stage 2, HIE implementation lags

Hospitals and healthcare systems made significant progress in adopting electronic health records in 2013, according to two studies published in the journal Health Affairs, but have a long road ahead of them to meet all the criteria for Meaningful Use (MU) Stage 2 and the implementation of health information exchanges (HIEs).

The authors of the studies and National Coordinator for Health Information Technology Karen DeSalvo spoke about the state of health IT at a briefing on the studies held today in Washington.

"We've made great investments and we need to build on them and weave together a fabric that serves everybody," DeSalvo said during her opening remarks.

The adoption of EHRs at hospitals, according to the first report, had a sharp spike in 2013. Fifty-eight percent of hospitals now have at least a basic EHR system, and most are able to meet some of the requirements under MU Stage 2. Those numbers show "phenomenal progress," said study author Ashish K. Jha, M.D., a professor of health policy and management at the Harvard School of Public Health, during the briefing.

"There is no country in the world that has moved this far, this fast on EHR adoption, certainly not on the hospital side," he said.

Despite the growth of EHR adoption, hospitals still struggle to meet all the requirements of MU Stage 2. By the end of 2013, only 5.8 percent were able to meet all the criteria, according to the first study.

Jha said there are large parts of MU that "most hospitals can do effectively--electronic prescribing, lab results, etc." But hospitals "get stuck" with other requirements, especially allowing for patient to access their data, he said.

The American Hospital Association released a statement on the studies, urging the Centers for Medicare & Medicaid Services and ONC "to take immediate steps to ensure the success of the Meaningful Use program, starting with finalizing the rule offering some limited flexibility in 2014 that was proposed in May."

The second study focused on HIEs among physicians. The adoption of HIEs is relatively low, according to the study. Four in 10 hospitals reported they can electronically share data with other providers and only 14 percent share data with ambulatory care providers or hospitals outside their organizations.

Julia Adler-Milstein, assistant professor at the School of Information at the University of Michigan and an author of the study, said during the briefing that there is a lot of work needed to improve sharing and that's why the ONC is making interoperability a priority.

"It's clear that even though the data is sitting in electronic health records, it's not being widely shared yet," she said.

DeSalvo said for the future, ONC will need to reset priorities pertaining to adoption as well as HIT strategic planning. She also emphasized the need to "set free" the collected information because it is time for it to follow the patients. 

To learn more:
- read the first study
- read the second study
- here's the AHA statement

Read more on