Physicians reported EHR use enhanced patient care overall. Clinical benefits were most likely to be reported by physicians using EHRs meeting Meaningful Use criteria and longer EHR experience.
The United States is making substantial investments to accelerate the adoption and use of interoperable electronic health record (EHR) systems. Using data from the 2009-13 Electronic Health Records Survey, we found that EHR adoption continues to grow: In 2013, 78 percent of office-based physicians had adopted some type of EHR, and 48 percent had the capabilities required for a basic EHR system. However, we also found persistent gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others. Physicians' electronic health information exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization. Finally, we found that 30 percent of physicians routinely used capabilities for secure messaging with patients, and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record. These findings suggest that although EHR adoption continues to grow, policies to support health information exchange and patient engagement will require ongoing attention.A ccelerating the adoption of health information technology (IT) has been recognized as a national policy priority for more than a decade. HITECH's goals are to promote the adoption and use of interoperable electronic health records (EHRs) and health information exchange (HIE), which can serve as the foundation for improvements in the cost and quality of the US health care delivery system. 3 In particular, modernizing the country's health IT infrastructure enables broader efforts to pursue new models of care delivery. To help move the country toward this goal, beginning in 2011 the Centers for Medicare and Medicaid Services (CMS) began making incentive payments to eligible professionals who demonstrated the regular use of specific computerized capabilities that meet meaningful-use objectives.
4Early evidence on the impact of HITECH suggested that its investments had accelerated the rate of EHR adoption. From 2010 to 2012 adoption of basic EHR systems and specific meaningful-use capabilities grew rapidly among US ambulatory care physicians.
5Physicians who previously had significantly lower rates of adoption, 6 including those who were older or worked in rural areas or areas with high rates of poverty, had the highest relative gains.
The US health care system is in the midst of an enormous change in the way health care providers and hospitals document, monitor, and share information about health and care delivery. Part of this transition involves a wholesale, but currently uneven, shift from paper-based records to electronic health record (EHR) systems. We used the most recent longitudinal survey of US hospitals to track how they are adopting and using EHR systems. Only 44 percent of hospitals report having and using what we define as at least a basic EHR system. And although 42.2 percent meet all of the federal stage 1 "meaningful-use" criteria, only 5.1 percent could meet the broader set of stage 2 criteria. Large urban hospitals continue to outpace rural and nonteaching hospitals in adopting EHR systems. The increase in adoption overall suggests that the positive and negative financial incentives currently in place across the US health care system are working as intended. However, achieving a nationwide health information technology infrastructure may require efforts targeted at smaller and rural hospitals.
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