The local environment affects a provider's ability to adopt and use interoperable health IT, according to an Urban Institute study recently released by the Office of the National Coordinator for Health IT.
The study looked at providers in Worcester, Massachusetts; Macon, Georgia.; Milwaukee; and Sacramento, California. All four areas have relatively high rates of electronic medical record adoption among physicians and hospitals, according to the study, "How Local Context Affects Providers' Adoption and Use of Interoperable Health Information Technology: Case Study Evidence from Four Communities in 2013 (Round Two)."
Respondents in the four healthcare communities noted common challenges in moving to Stage 2 of Meaningful Use, including the aggressive timeline, patient participation, ICD-10 implementation and reforms such as accountable care organizations (ACOs).
But success varied by community with factors such as how the provider market was structured, state health policies, public and private incentives promoting healthcare quality and innovation, and the strength and longevity of local health information exchanges (HIEs), Urban Institute researchers found.
Other challenges that were location-specific included:
- The effectiveness of regional extension centers (RECs) varied by region, and "smaller, rural providers in some communities might need more special attention and customized strategies"
- Some RECs might have to charge for their services or close as federal funding ends, especially in states that aren't planning to kick in any funding; ONC reported recently that 93 percent of RECs are expected to be self-sustaining when its initial investment ends this year, and in a HIMSS poll, 85 percent said they expect to stay open after this year with new funding sources
- State HIEs "had various implementation challenges and could face additional complications moving forward"
"Moving forward toward Stage 3 MU and beyond, health reform and other health system changes could be improved with additional input from local communities, as state policymakers, regional insurers, and local health care systems play an increasingly important role in promoting MU and health information exchange," the researchers concluded.
For more information:
-here's the study (.pdf)