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U.S. Hospitals Triple Use of Electronic Health Records: Report
System allows sharing of latest information on patients' test results, treatments and meds
Monday, July 8, 2013
The number of hospitals with a basic electronic health records (EHRs) system tripled from 2010 to 2012, with more than four of every 10 hospitals now equipped with the new health information technology, according to the report scheduled for Tuesday release by the Robert Wood Johnson Foundation.
"Given the size of our country, that's amazing progress in a very short time period," said report co-author Dr. Ashish Jha, an associate professor with the Harvard School of Public Health.
However, there is much more work to be done, the report indicates. These systems may have been adopted, but hospitals have not yet figured out how to use the new technology to improve patient safety and reduce health care costs.
For example, the study found that 42 percent of hospitals now meet federal standards for collecting electronic health data, but only 5 percent also meet federal standards for exchanging that data with other providers to allow widespread physician access to a patient's records.
"The news here is mostly good, but we shouldn't declare victory yet," Jha said. "In other industries it takes about 10 years after technology is adopted to see real efficiencies. My hope is we'll see that more quickly in health care. We don't have 10 years to waste."
Researchers believe that three factors have combined to drive adoption of electronic health records -- society's increasing reliance on information technology, new federal funding to support purchase of EHR systems, and future penalties under the Affordable Care Act that will be assessed against providers who will not use EHRs.
"It's the right incentives at the right time," Jha said. "Doctors and hospitals have been thinking about buying electronic health records [systems] for some time. This is where our society is moving. But the finances have been a challenge. The federal incentives have been very well targeted. They were well designed to help push hospitals and doctors to adopt EHRs."
Jha added that penalties for failure to act on electronic health records should not be underestimated as a motivating factor. "They are signaling if you don't do it, a few years down the road we're going to start paying you less," he said. "That motivates people to say, 'whoa, I'd better get on board.'"
The report found that electronic health record adoption has increased throughout the American health care system. It's not just big hospitals in major metropolitan centers that are purchasing the new technology. The number of rural hospitals with an EHR system increased from about 10 percent to 33.5 percent between 2010 and 2012, while urban hospitals saw EHR adoption rates rise from 17 percent to nearly 48 percent.
"We saw a tremendous amount of activity throughout all subtypes of hospitals," said co-author Catherine DesRoches, a senior scientist at Mathematica Policy Research. "The rate at which they are adopting has increased quite a bit."
The next step, in which health data is shared between providers, will be key to realizing the true potential of EHRs, DesRoches said.
For example, patient safety should improve when doctors will have automatic access to a person's health records, which allows them up-to-date information on medications prescribed, tests performed and treatments initiated.
"It also has the potential to help with costs," she said. "If you're a patient and you get to your appointment and the specialist can see all of the tests that have already been ordered, they're not going to order duplicate tests or ordering medications that might be contraindicated. The information's right there in the record."
While the United States lags on effective EHR sharing, the report found reason for optimism. More health care providers are participating in initiatives that ultimately will connect their own electronic records systems to community-wide information exchanges.
About one in four hospitals is now participating in health information exchange initiatives, up from 14 percent in 2010. Participation of outpatient practices in these initiatives has increased to 10 percent these days from 3 percent in 2010.
"People who say we haven't achieved those things and so it's a waste, I caution them that it takes a while," Jha said. "It's going to take a little while to get electronic health records right. We just have to be patient and work hard."
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