More hospitals than ever have implemented electronic health records, but challenges and the adoption gap have not dissipated, according to new research published in Health Affairs.
The study's authors, including Julia Adler-Milstein from the University of Michigan, reviewed data from the 2009-14 American Hospital Association Annual Survey of Hospital-IT Supplement. They found that three quarters (75.2 percent) of hospitals have adopted at least a basic EHR in 2014, up from 58.9 percent in 2013, a continuation of annual double digit percentage point progress since 2010. Of those hospitals that hadn't adopted a basic system, many were close to achieving the 10 EHR functionalities that would constitute a basic EHR.
Larger, urban, nonprofit and major teaching hospitals were more likely to have a comprehensive EHR system. However, many of the hospitals that have not yet adopted an EHR may be those who face the biggest challenges in doing so. For instance, 32 percent of critical access hospitals have not yet adopted a basic EHR system, compared to 21.9 percent of non-critical access hospitals.
Other challenges reported by hospitals included the startup and ongoing costs of the systems, obtaining physician cooperation and the complexity of meeting the Meaningful Use criteria within the required time frames. While there was roughly a sevenfold increase in the number of hospitals that were ready for Stage 2 of Meaningful Use from 2013 to 2014, that amounted to only 40.5 percent of hospitals.
The researchers suggest that policymakers respond to calls to delay Stage 3 of Meaningful Use and streamline regulations to free up resources to so hospitals can focus on complementary priorities, such as transitioning to value-based care. They also recommend addressing the financial challenges, as well as the gaps in EHR adoption, which were "persistent."
The study mirrors other reports. EHR adoption has increased, but physicians are still not embracing them; the disparity in adoption remains a threat to patient care and national interoperability.
To learn more:
- read the study