Health Information Technology in the United States

Progress and Challenges Ahead, 2014

A doctor seeking information on a computer, two nurses are in the background.

Adopting EHRs is the first step in a long and complex journey to an IT-enabled health care system in which technology is effectively leveraged to address ongoing cost and quality challenges.

This annual report produced by a team of researchers at the Robert Wood Johnson Foundation, Mathematica Policy Research, Harvard School of Public Health, and the University of Michigan tracks the progress of adoption of electronic health records (EHRs). 

In 2013, the percent of hospitals adopting at least a basic EHR quadrupled to 58.9 percent from 2010 when the EHR incentive program was implemented.

 

EHR Incentive Programs:

  • As of December 2013, some 63.8 percent of eligible hospitals received meaningful use EHR incentives, up from 45.4 percent in 2011.
  • About 41 percent of eligible physician providers received incentive payments in 2012, nearly twice the rate of 2011 (21%). However, 61 percent of providers who received Medicaid-related payments in 2011 did not receive them in 2012.

Physician Adoption and Use of Health Information Technology:

  • Thirty-three percent of primary care physicians with a basic EHR received timely information from specialists about clinical care and test results (versus 22% of those without).

Evidence of a Digital Divide:

  • The digital divide is lessening as safety-net providers benefit from special incentive structures for adopting EHRs.
  • Critical access hospitals, which are small and serve rural and often poor areas, have basic EHRs; fewer have comprehensive EHRs (19.9%) compared to noncritical access hospitals (27.7%).

Optimizing EHR Use to Drive Performance Improvement:

  • Sharing of electronic health information among acute care hospitals is not widespread. For example, 26 percent of hospitals share patient medication history electronically with hospitals outside their system.
  • Decision support related to medication safety has been widely adopted (81% of hospitals).
  • About 77 percent of hospitals measure organizational performance using EHRs.

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