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Study: In Use of Advanced EHR Functions, Digital Divide is Emerging

August 25, 2017
by Heather Landi
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While most hospitals have adopted electronic health records (EHRs), a recent study found evidence that use of advanced EHR functions lags and that a digital divide appears to be emerging, with critical-access hospitals in particular lagging behind.

In a study published in the August issue of the Journal of the American Medical Informatics Association, research led by Julia Adler-Milstein of the University of Michigan Schools of Information and Public Health examined EHR adoption in U.S. hospitals and the emergency of a digital “advanced use” divide.

Co-authors of the study include A Jay Holmgren, also from the University of Michigan; Peter Kralovec, Health Forum; Chantal Worzala from the American Hospital Association; Talisha Searcy from the Office of the National Coordinator for Health Information Technology and Vaishali Patel from ONC.

The study authors note that while most hospitals have adopted EHRs, healthcare policy researchers know little about whether hospitals use EHRs in advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources—small, rural, safety-net—are keeping up.

Using 2008–2015 American Hospital Association Information Technology Supplement survey data, the researchers measured “basic” and “comprehensive” EHR adoption among hospitals to provide the latest national numbers. The researchers also used new supplement questions to assess advanced use of EHRs and EHR data for performance measurement and patient engagement functions.

The study findings indicate that 80 percent of hospitals adopted at least a basic EHR system, a 5.3 percentage point increase from 2014. However, only 37 percent of hospitals adopted at least 8 (of 10) EHR data for performance measurement functions, and 42 percent of hospitals adopted at least 8 (of 10) patient engagement functions.

And, the study found that critical access hospitals were less likely to have adopted at least 8 performance measurement functions and at least 8 patient engagement functions.

The study authors concluded that while the Health Information Technology for Economic and Clinical Health Act (HITECH) resulted in widespread hospital EHR adoption, “use of advanced EHR functions lags and a digital divide appears to be emerging, with critical-access hospitals in particular lagging behind.”

“This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance,” the study authors wrote.

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