Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist
Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist
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DOI：
10.1377/hlthaff.2015.0992
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发表时间：
2015-12-01
期刊：
影响因子：
9.7
通讯作者：
Jha, Ashish K.
中科院分区：
文献类型：
--
作者：
Adler-Milstein, Julia;DesRoches, Catherine M.;Jha, Ashish K.
在全国范围内采用电子健康记录仍然是一个重要的政策优先事项。虽然自2010年以来，电子健康记录的采用率稳步上升，但由于联邦激励措施已转变为惩罚措施，目前还不清楚尚未采用电子健康记录的提供者将如何应对。我们使用2008-14年的国家数据，其中包括最近可用的，以检查医院EHR的趋势。我们发现采用率大幅提高，75%的美国医院现在至少采用了基本的EHR系统，高于2013年的59%。然而，小型和农村医院仍然落后。在没有基本的EHR系统的医院中，最经常尚未采用的功能（61%的医院）是医生笔记。我们还看到，满足核心阶段2有意义使用标准的能力大幅提高（40.5%的医院，高于2013年的5.8%）;这一进展的大部分原因是，在护理过渡期间，满足与患者和其他医生交换健康信息相关标准的能力有所提高。最后，医院最常报告的前期和持续成本，医生合作，以及满足有意义的使用标准的复杂性作为挑战。我们的研究结果表明，全国范围内的医院采用EHR是可以实现的，但需要关注小型和农村医院以及应对财务挑战的战略，特别是现在对缺乏采用的惩罚已经开始。
Achieving nationwide adoption of electronic health records (EHRs) remains an important policy priority. While EHR adoption has increased steadily since 2010, it is unclear how providers that have not yet adopted will fare now that federal incentives have converted to penalties. We used 2008-14 national data, which includes the most recently available, to examine hospital EHR trends. We found large gains in adoption, with 75 percent of US hospitals now having adopted at least a basic EHR system-up from 59 percent in 2013. However, small and rural hospitals continue to lag behind. Among hospitals without a basic EHR system, the function most often not yet adopted (in 61 percent of hospitals) was physician notes. We also saw large increases in the ability to meet core stage 2 meaningful-use criteria (40.5 percent of hospitals, up from 5.8 percent in 2013); much of this progress resulted from increased ability to meet criteria related to exchange of health information with patients and with other physicians during care transitions. Finally, hospitals most often reported up-front and ongoing costs, physician cooperation, and complexity of meeting meaningful-use criteria as challenges. Our findings suggest that nationwide hospital EHR adoption is in reach but will require attention to small and rural hospitals and strategies to address financial challenges, particularly now that penalties for lack of adoption have begun.