Electronic Health Records in Ambulatory Care — A National Survey of Physicians

DesRoches, Catherine M.; Campbell, Eric G.; Rao, Sowmya R.; Donelan, Karen; Ferris, Timothy G.; Jha, Ashish K.; Kaushal, Rainu; Levy, Douglas E.; Rosenbaum, Sara; Shields, Alexandra E.; Blumenthal, David

doi:10.1056/nejmsa0802005

Cited by 903 publications

(743 citation statements)

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“…This definition has been applied in several national studies and reports, and has evolved over time to include newer functionalities. 3,4 However, neither of these measures captures the full set of functionalities needed to assess how ready physicians are to meet the MU criteria. We constructed a measure that assessed whether physicians had adopted EHRs with the 15 required "core" functionalities for the first stage of meaningful use, by mapping the "core" functionalities to items in the survey that assess EHR functionality by year, from 2008 to 2011.…”

Section: Measures Of Ehr Adoptionmentioning

confidence: 99%

“…Physicians using EHRs with advanced functionalities have reported greater benefits from using EHRs. 4 Furthermore, certain MU functionalities such as CPOE, electronic prescribing and clinical decision support have been associated with improvements in care. 2,[23][24][25][26][27][28][29][30] However, the full clinical benefits of MU have yet to be empirically evaluated and warrant future research.…”

Section: %)mentioning

confidence: 99%

“…3 Numerous barriers to physician adoption have been identified. 4 They include problems with practices' capacity to implement technology and misaligned incentives that result in practices bearing the full costs of implementing systems, while many benefits accrue to patients and insurers. Certain types of physicians or practices may be more likely to experience these barriers and have lower adoption rates.…”

Section: Introductionmentioning

confidence: 99%

“…Certain types of physicians or practices may be more likely to experience these barriers and have lower adoption rates. [4][5][6][7][8] Recent federal HIT policy initiatives seek to address these barriers, especially among physicians who may not have the means and capabilities to readily adopt HIT. Beginning in 2011, the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 made incentive payments available for eligible physicians who demonstrated 'meaningful use' (MU) of EHRs that possess functionalities capable of meeting specific criteria.…”

Section: Introductionmentioning

confidence: 99%

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Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

et al. 2013

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Section: Measures Of Ehr Adoptionmentioning

confidence: 99%

Section: %)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Variation in Electronic Health Record Adoption and Readiness for Meaningful Use: 2008–2011

et al. 2013

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“…Computing technology has transformed virtually every aspect of our daily life, however the proportion of U.S. health care professionals and hospitals that have transitioned to EHRs is remarkably small [4,7]. The barriers include cost, technical challenges, interoperability, privacy and confidentiality and an adequate HIT workforce.…”

Section: Ehrs In Orthopaedicsmentioning

confidence: 99%

ABJS Carl T. Brighton Workshop on Health Informatics in Orthopaedic Surgery: Editorial Comment

Veillette

2010

Clinical Orthopaedics &Amp; Related Research

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The economic woes of the United States (U.S.) healthcare system have given rise to an unprecedented federal effort to modernize the information systems and promote the adoption of health information technology (HIT). The recent economic stimulus package-the American Recovery and Reinvestment Act of 2009 (ARRA)-has a HIT component (HITECH Act) that will allocate $17 billion in financial incentives intended to persuade doctors and hospitals to adopt meaningful use of an electronic health record (EHR) and $2 billion for support systems and requisite infrastructure [1,2]. The purpose of the HITECH Act is to encourage health care providers to leverage HIT tools to achieve quality and efficiency goals. Although this primary value proposition for HIT adoption by health care professionals remains a matter of debate, the potential for secondary benefits such as the reuse of clinical data for research and quality improvement is inevitable [8].The U.S. is not alone in their efforts to adopt HIT. The United Kingdom's NHS Connecting for Health (http://www.informatics.nhs.uh), Australia's HealthConnect (www.healthconnect.gov.au) and Canada's Health Infoway (www.infoway-inforoute.ca) represent three such efforts at different stages of implementation. EHRs, however, are just one of the many tools of health informatics. The tools of informatics encompass clinical guidelines and decision support, formal health languages, information systems (EHRs, PACS, integrated databases and registries) and communication systems (Internet, telemedicine). It is important to remember that these tools are only a means to an end-the delivery of the best possible healthcare.Informatics is the intersection of people, information and technology. Within the field of informatics are several major subcategories, each with their own domain (Fig. 1). Health informatics has been defined broadly as the logic of healthcare [3]. It is a field concerned with the optimal use of information, often aided by technology, to improve individual health, health care, public health, and biomedical research [6].Substantial differences have been identified between various clinical fields to justify the creation of areas of ''subspecialty'' informatics. Certainly there is enough uniqueness in our information needs, those of our patients and the technologies we routinely use to make clinical decisions to warrant the existence of orthopaedic informatics. Orthopaedic informatics is therefore the logic of orthopaedics-the rational study of the way we think about patients: the way we define, select and evolve treatments; how we create, share and apply clinical knowledge; the information needs of our consumers. It is aided by informatics tools to obtain the information we need in the appropriate detail, of the appropriate quality, when we need it, where we need it, to improve the efficiency and effectiveness of patient care, research and education. Informatics skills underpin communicating effectively, structuring information, questioning to find information, searching for knowl...

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