- There remains an EHR gap in healthcare despite many hospitals adopting EHRs and using the technology to “support performance measurement and patient engagement,” according to a new study in the Journal of the American Medical Informatics Association (JAMIA).
The study found nearly 81% of hospitals adopted at least a basic EHR system, which is 5 percentage points better than 2014. However, only 38% of hospitals have adopted at least eight of 10 EHR data for performance measurement functions and 42% adopted at least eight patient engagement functions.
The study found this is especially a problem for critical access hospitals.
Studies have shown that the Health Information Technology for Economic and Clinical Health Act’s meaningful use incentive program led to more hospital EHR adoption, but this new study discovered there are still issues and emerging digital divides. “This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance,” the researchers wrote.
EHR technology still has a number of problems that need to be solved, like interoperability difficulties and ease of use for providers, but their potential is significant. Much of the work surrounding initial adoption of EHRs is winding down. The next step is pushing health systems to discover all the ways electronic records can be used.
The survey shows that not only is there a gap among hospitals, but types of physicians also differ in EHR adoption. A recent CDC National Electronic Health Records Adoption Survey found office-based cardiologists (95.6%), neurologists (94.5%) and urologists (94%) have the highest adoption rates.General/family practice ranked sixth with psychiatrists the least likely to use EHRs (61.3%).
EHR usage also varied widely by state, with Delaware at nearly 99%, while Louisiana finished last with almost 75%. The report found 19 states had physician use rates of 90% or above. It also found nearly 87% of office-based U.S. physicians use some form of EHR.
In the new JAMIA study, researchers said they wanted to see whether hospitals are using EHRs in "advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources — small, rural, safety-net — are keeping up."
Researchers used 2008-2015 American Hospital Association Information Technology Supplement survey data to measure “basic” and “comprehensive” EHR adoption among the hospitals. They also sent an additional survey to assess advanced use of EHRs and EHR data for performance measurement and patient engagement functions.
The study authors sent those surveys to 6,290 hospitals and received responses from 3,538 facilities. Finally, they ran logistic regression models to spot “hospital characteristics associated with high adoption in each advanced use domain” to find a digital advanced use divide.
The study's results are concerning. Yes, more hospitals are using EHRs, but in many cases they're not being used to their capacity. If healthcare organizations are going to use EHRs to better care and outcomes, they will need to fully integrate the systems and adopt performance measurement and patient engagement functions.