Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program

Samuel, Cleo A.

doi:10.1136/amiajnl-2013-002347

Cited by 16 publications

(20 citation statements)

References 12 publications

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“…Training was combined with maintenance and upgrades [ 8 , 12 , 21 , 24 ]. The barrier of Staff shortages was combined with overworked [ 2 , 27 , 40 ]. Privacy was combined with security [ 10 , 36 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Location is a difficult barrier to overcome. It is not a mystery to anyone that rural communities often struggle to overcome barriers such as cost, bandwidth, and user/patient acceptance, a point supported by the literature [ 2 , 7 , 15 , 22 , 29 ]. Unfortunately, very few solutions are offered to this group; at a minimum policy should look to assist those who lag behind the rest of the adopters [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Currently in the United States, expenditures associated with health care average 17.5% of the gross domestic product (GDP) [ 1 ]. The Health Information Technology for Economic and Clinical Health (HITECH) Act was initiated in 2009 and, as described by Samuel (2014), implemented goals of “widespread” adoption of Electronic Health Records (EHRs) that should realize nationwide savings in the health care industry [ 2 ]. Although much research exists in support of the policy makers’ agenda tied to the HITECH Act, the widespread adoption process leaves many providers reluctant to move forward due to concerns of financial pressures, technology limitations, and potential unintended errors related to limited knowledge of the EHR [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Adoption Factors of the Electronic Health Record: A Systematic Review

Kruse¹,

Kothman²,

Anerobi³

et al. 2016

JMIR Med Inform

114

103

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BackgroundThe Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures.ObjectiveThe purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States.MethodsAuthors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity.ResultsGroup members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues.ConclusionsThe 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite incentives in the HITECH Act. Limited financial backing and outdated technology were also common barriers frequently mentioned during data review. Future public policy should include incentives commensurate with those in the HITECH Act to maintain strong adoption rates.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adoption Factors of the Electronic Health Record: A Systematic Review

Kruse¹,

Kothman²,

Anerobi³

et al. 2016

JMIR Med Inform

114

103

View full text Add to dashboard Cite

show abstract

“…Infrastructure and workforce related barriers continue to exist for EHR adoption (Skillman et al, 2014) and market forces of physicians' supply in turn may impact this as well. A recent study has found that health professional shortage area was negatively associated with EHR adoption (Samuel, 2014). Previous studies have also found that physicians located in counties with higher physician concentration were more likely to adopt EHRs (Abdolrasulnia et al, 2008).…”

Section: Physician Densitymentioning

confidence: 98%

“…Other studies have addressed state-level or regional differences (Abramson et al, 2014;Samuel, 2014). However the Abramson study limited itself to the adoption of EHR in nursing homes.…”

Section: Background and Significancementioning

confidence: 99%

Macro influencers of electronic health records adoption

Raghavan

Chinta

Zhirkin

2015

IJEH

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While adoption rates for electronic health records (EHRs) have improved, the reasons for significant geographical differences in EHR adoption within the USA have remained unclear. To understand the reasons for these variations across states, we have compiled from secondary sources a profile of different states within the USA, based on macroeconomic and macro health-environment factors. Regression analyses were performed using these indicator factors on EHR adoption. The results showed that internet usage and literacy are significantly associated with certain measures of EHR adoption. Income level was not significantly associated with EHR adoption. Per capita patient days (a proxy for healthcare need intensity within a state) is negatively correlated with EHR adoption rate. Health insurance coverage is positively correlated with EHR adoption rate. Older physicians (>60 years) tend to adopt EHR systems less than their younger counterparts. These findings have policy implications on formulating regionally focused incentive programs.

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Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics

Tong

Tan

et al. 2018

J Med Syst

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The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The factors are interrelated with the others. The adoption factors identified are multifaceted, ranging from technological characteristics, clinician-technology interactions, skills and knowledge, and the user-workflow-technology fit. Other findings, which have been relatively underrepresented in previous studies, contribute unique insights about the influence of work and social environment on the adoption of EMRs, including limited clinic space and the effects of physicians' decision to use the technology on clinical staffs' adoption decisions. Potential strategies to address the concerns, overcome adoption barriers, and define relevant policies are discussed.

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Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program

Abstract: Federal efforts to spur EHR adoption and MU have demonstrated some early success; however, some geographic variations in EHR diffusion indicate that greater attention needs to be paid to ensuring equitable uptake and use of EHRs throughout the US.

Cited by 16 publications

References 12 publications

Adoption Factors of the Electronic Health Record: A Systematic Review

Adoption Factors of the Electronic Health Record: A Systematic Review

Macro influencers of electronic health records adoption

Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics

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