Small, Nonteaching, And Rural Hospitals Continue To Be Slow In Adopting Electronic Health Record Systems

DesRoches, Catherine M.; Worzala, Chantal; Joshi, Maulik; Kralovec, Peter; Jha, Ashish K.

doi:10.1377/hlthaff.2012.0153

Cited by 120 publications

(84 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, meaningful-use requirements and the further growth in hospitals' adoption of certified EHR systems may become important drivers of information exchanges. 21 The State Health Information Exchange Cooperative Agreement Program at the Office of the National Coordinator for Health Information Technology has included hospitals' exchange of clinical summaries as part of its state-level performance measurement and will monitor the effectiveness of the various state approaches in increasing low rates of exchange activity. 31 National standards for interoperability have been developed that will provide reusable templates to serve as building blocks to accelerate the use of standards-based clinical summaries.…”

Section: Discussionmentioning

confidence: 99%

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

et al. 2013

View full text Add to dashboard Cite

Electronic health information exchange can improve care coordination for patients by enabling more timely and complete sharing of clinical information among providers and hospitals. Approaches to health information exchange have expanded in recent years with the growth in entities such as regional health information organizations (HIOs) and the increased adoption of electronic health record (EHR) systems. However, little is known about the extent of exchange activity in US hospitals. Using national surveys of hospitals, we found that between 2008 and 2012, hospitals' electronic exchange of health information with other providers increased significantly, regardless of provider type, organizational affiliation, or type of clinical information. In 2012 nearly six in ten hospitals actively exchanged electronic health information with providers and hospitals outside their organization, an increase of 41 percent since 2008. EHR adoption and HIO participation were associated with significantly greater hospital exchange activity, but exchanges with providers outside the organization and exchanges of clinical care summaries and medication lists remained limited. New and ongoing policy initiatives and payment reforms may accelerate the electronic exchange of health information by creating new data exchange options, defining standards for interoperability, and creating payment incentives for information sharing across organizational boundaries. C linical information-such as laboratory results and medication listsideally should follow patients as they move across different care settings, even those that do not share an organizational affiliation. However, gaps in communication and poor transmission of information commonly occur during transitions between hospitals and primary care providers, and the sharing of patient data among hospitals is probably even more limited.1 Addressing these information gaps is critical because the timely sharing of a patient's clinical information can improve the accuracy of diagnoses, reduce the number of duplicative tests, prevent readmissions, and prevent medication errors. 2-4One way to facilitate the sharing of various types of clinical information among providers and hospitals is electronic health information exchange. Historically, regional health information organizations (HIOs)-entities that can connect a myriad of stakeholders, including laboratories, public health departments, hospitals, and providers-have served as key facilitators of local exchanges of information. 5Hospitals and providers can also electronically exchange clinical information via interoperable electronic health record (EHR) systems and patient portals. Federal policies have sought to expand various

show abstract

Section: Discussionmentioning

confidence: 99%

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Some studies have found that EHRs may not improve treatment efficiencies or quality of care for patients with multiple disorders (Harman et al, 2012;McCormick et al, 2012). In addition, development and implementation of EHRs may involve substantial commitment of organizational resources that may affect other aspects of system functioning (Chaudhry et al, 2006;DesRoches et al, 2012;Vest, 2010). Nonetheless, field leadership is nearly unanimous in pressing EHR implementation as a critical strategic organizational decision for SUD treatment providers (Lewis et al, 2013;Molfenter et al, 2012).…”

Section: S Ubstance Use Disorder (Sud) Treatment Organizations Have Bmentioning

confidence: 99%

Implementation of Electronic Health Records and Entrepreneurial Strategic Orientation in Substance Use Disorder Treatment Organizations

Fields

Riesenmy

Blum

et al. 2015

J. Stud. Alcohol Drugs

View full text Add to dashboard Cite

ABSTRACT. Objective: This research studied the relationships of the components of entrepreneurial strategic orientation (ESO) with implementation of electronic health records (EHRs) within organizations that treat patients with substance use disorders (SUDs). Method: A national sample of 317 SUD treatment providers were studied in a period after the Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted (2009) and meaningful use EHR requirements were established (2010), but before implementation of the Affordable Care Act. The study sample was selected using stratified random sampling and was part of a longitudinal study of treatment providers across the United States. Results: After we controlled for potentially confounding variables, four components of ESO had a significant relationship with EHR implementation. Levels of slack resources in an organization moderated the relationship of ESO with meaningful use of EHRs, increasing the strength of the relationship for some components but reducing the strength of others. Conclusions: From a policy and practice perspective, the results suggest that training and education to develop higher levels of ESO within SUD treatment organizations are likely to increase their level of meaningful use of EHRs, which in turn may enhance the integration of SUD treatment with primary medical providers, better preparing SUD treatment providers for the environmental changes of the Affordable Care Act. (J. Stud. Alcohol Drugs, 76, 942-951, 2015)

show abstract

“…48 Although solo practitioners, small group practices, nonteaching hospitals, and rural practices tend to adopt EHRs more slowly, the proportion of all persons with health data in EHRs continues to increase. 55 The promise of EHR-based population health surveillance will rely significantly on efforts under way by providers and health care facilities to join their EHR systems in networks capable of sharing data for clinical and administrative purposes, provided that such networks also enter into agreements with organizations seeking to monitor population health, such as health departments. Core goals of the organizations generating EHR data (eg, health care delivery systems, HIEs) differ from those of target users for population health surveillance (eg, public health agencies), raising challenges in uniting stakeholders.…”

Section: Challengesmentioning

confidence: 99%

The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review

Paul

Greene

Newton-Dame

et al. 2015

Population Health Management

View full text Add to dashboard Cite

Electronic health records (EHRs) are transforming the practice of clinical medicine, but the extent to which they are being harnessed to advance public health goals remains uncertain. Data extracted from integrated EHR networks offer the potential for almost real-time determination of the health status of populations in care, for targeting interventions to vulnerable populations, and for monitoring the impact of such initiatives over time. This is especially true in ambulatory care settings, which are uniquely suited for monitoring population health indicators including risk factors and disease management indicators associated with chronic diseases. As efforts gather steam to integrate health data across delivery systems, large networks of electronic patient information are increasingly emerging. Few of the national population health surveillance systems that rely on EHR data have progressed beyond laying groundwork to launch and maintain EHR-based surveillance, but a limited number of more focused or local efforts have demonstrated innovation in population health surveillance. Common challenges include incompleteness of population coverage, lack of interoperability across data systems, and variable data quality. This review defines progress, opportunities, and challenges in using EHR data for population health surveillance.

show abstract

Small, Nonteaching, And Rural Hospitals Continue To Be Slow In Adopting Electronic Health Record Systems

Cited by 120 publications

References 5 publications

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

Hospital Electronic Health Information Exchange Grew Substantially In 2008–12

Implementation of Electronic Health Records and Entrepreneurial Strategic Orientation in Substance Use Disorder Treatment Organizations

The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review

Contact Info

Product

Resources

About