Reconsidering hospital EHR adoption at the dawn of HITECH: implications of the reported 9% adoption of a "basic" EHR.
J Am Med Inform Assoc
; 27(8): 1198-1205, 2020 08 01.
Article
em En
| MEDLINE
| ID: mdl-32585689
ABSTRACT
OBJECTIVE:
In 2009, a prominent national report stated that 9% of US hospitals had adopted a "basic" electronic health record (EHR) system. This statistic was widely cited and became a memetic anchor point for EHR adoption at the dawn of HITECH. However, its calculation relies on specific treatment of the data; alternative approaches may have led to a different sense of US hospitals' EHR adoption and different subsequent public policy. MATERIALS ANDMETHODS:
We reanalyzed the 2008 American Heart Association Information Technology supplement and complementary sources to produce a range of estimates of EHR adoption. Estimates included the mean and median number of EHR functionalities adopted, figures derived from an item response theory-based approach, and alternative estimates from the published literature. We then plotted an alternative definition of national progress toward hospital EHR adoption from 2008 to 2018.RESULTS:
By 2008, 73% of hospitals had begun the transition to an EHR, and the majority of hospitals had adopted at least 6 of the 10 functionalities of a basic system. In the aggregate, national progress toward basic EHR adoption was 58% complete, and, when accounting for measurement error, we estimate that 30% of hospitals may have adopted a basic EHR.DISCUSSION:
The approach used to develop the 9% figure resulted in an estimate at the extreme lower bound of what could be derived from the available data and likely did not reflect hospitals' overall progress in EHR adoption.CONCLUSION:
The memetic 9% figure shaped nationwide thinking and policy making about EHR adoption; alternative representations of the data may have led to different policy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Difusão de Inovações
/
Registros Eletrônicos de Saúde
/
American Recovery and Reinvestment Act
/
Administração Hospitalar
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article