Progress And Challenges: Implementation And Use Of Health Information Technology Among Critical-Access Hospitals

Abstract

Despite major national investments to support the adoption of health information technology (IT), concerns persist that barriers are inhibiting that adoption and the use of advanced health IT capabilities in rural areas in particular. Using a survey of Medicare-certified critical-access hospitals, we examined electronic health record (EHR) adoption, key EHR functionalities, telehealth, and teleradiology, as well as challenges to EHR adoption. In 2013, 89 percent of critical-access hospitals had implemented a full or partial EHR. Adoption of key EHR capabilities varied. Critical-access hospitals that had certain types of technical assistance and resources available to support health IT were more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use, compared to other hospitals in the survey. It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader health care system.

Long-Term Kidney Allograft Survival in Patients With Transplant Glomerulitis

“…24 Future efforts should work toward using both the EHR and HIEx to compile much larger datasets that include transplant recipients from multiple centers while also leveraging larger amounts of dynamic clinical data. 25,26 Previous studies assessing risk factors for early hospital readmission after kidney transplant have demonstrated similar findings to this analysis. The aforementioned analysis by McAdams-DeMarco demonstrated that baseline recipient demographics (age, BMI, comorbidities), donor characteristics (age, DCD, expanded criteria donor), and transplant factors (cold time, induction therapy, human leukocyte antigen mismatches, and DGF) were all statistically associated with readmission.…”

Inclusion of Dynamic Clinical Data Improves the Predictive Performance of a 30-Day Readmission Risk Model in Kidney Transplantation

“…24 Future efforts should work towards using both the EHR and HIEx to compile much larger datasets that include transplant recipients from multiple centers while also leveraging larger amounts of dynamic clinical data. 25, 26 …”

Assessing HITECH Implementation and Lessons: 5 Years Later

“…Concerned that workforce limitations would serve as barriers to progress in EHR adoption, especially for small and rural physician practices and critical access hospitals, HITECH included front‐end funding for programs to support staff training in the relevant skills required by the HITECH Act.…”