Beginning in fiscal year 2015, institutions that bill the Medicare program and fail to demonstrate stage 2 meaningful use of electronic health records will be subject to a penalty. To assess the current state of hospital EHR adoption, the authors of a study published this month on HealthAffairs.org reviewed data from the 2013 American Hospital Association Annual Survey of Hospitals-IT Supplement and found that 59% of hospitals had adopted basic or comprehensive EHR quadruple the percentage for 2010. According to the authors, while at least 90% of the hospitals were able to meet many of the stage 2 meaningful-use criteria, only 5.8% of hospitals were able to meet them all.
The study also found that the digital divide a difference in adoption rates between safety-net hospitals serving poor patients compared with better-resourced hospitals has not materialized. The authors did, however, find a gap in EHR adoption among small, rural and critical-access hospitals and other institutions. The struggle of many hospitals to meet stage 2 meaningful-use criteria suggests that the path forward remains challenging, and a particular focus on building data exchange infrastructure may be needed to support the nations health and care improvement goals, the authors wrote.
The studys other findings include:
Hospitals were more likely to have a basic EHR if they were large, urban, nonprofit and major teaching hospitals. Critical-access hospitals were no less likely than other hospitals to have adopted a basic EHR, but were significantly less likely to have adopted a comprehensive EHR.
Between 2012 and 2013, 24.4% of hospitals adopted a basic EHR. These recent adopters were significantly less likely than early adopters to be large, nonprofit or major teaching hospitals.
Recent adopters were significantly more likely to be located in rural areas instead of urban areas and to be a critical-access hospital.
Although only 5.8% of hospitals met the measure for stage 2 meaningful-use readiness, the vast majority of hospitals reported being able to meet many stage 2 objectives, including using their EHR to record vital signs, smoking status and patient demographic characteristics; incorporate clinical lab test results as structured data; generate patient lists by specific conditions; provide patient-specific educational resources; and track medications using electronic medication administration records.
The study also found EHR adoption rates are approximately equivalent among hospitals that care for poor patients and those caring for more affluent patients. Critical-access hospitals, which primarily serve rural populations, remain somewhat behind, however.
Many hospitals have key features required for stage 2 meaningful use. But important capabilities such as providing patients with the ability to view online, download and transmit their data and sending summaries of care when patients transition between care settings have not been widely adopted.
Despite the substantial increase in EHR adoption, meeting stage 2 meaningful-use objectives will require work for the vast majority of hospitals, the authors wrote. Our findings suggest that functions related to electronic data exchange, both with other providers and with patients (in particular, providing summaries of care during transitions and giving patients the ability to view online, download and transmit their health information) are critical gaps.
See the study: http://content.healthaffairs.org/content/early/2014/08/05/hlthaff.2014.0453.full