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Sequencing of EHR adoption among US hospitals and the impact of meaningful use

Sequencing of EHR adoption among US hospitals and the impact of meaningful use AbstractObjective To examine whether there is a common sequence of adoption of electronic health record (EHR) functions among US hospitals, identify differences by hospital type, and assess the impact of meaningful use.Materials and methods Using 2008 American Hospital Association (AHA) Information Technology (IT) Supplement data, we calculate adoption rates of individual EHR functions, along with Loevinger homogeneity (H) coefficients, to assess the sequence of EHR adoption across hospitals. We compare adoption rates and Loevinger H coefficients for hospitals of different types to assess variation in sequencing. We qualitatively assess whether stage 1 meaningful use functions are those adopted early in the sequence.Results There is a common sequence of EHR adoption across hospitals, with moderate-to-strong homogeneity. Patient demographic and ancillary results functions are consistently adopted first, while physician notes, clinical reminders, and guidelines are adopted last. Small hospitals exhibited greater homogeneity than larger hospitals. Rural hospitals and non-teaching hospitals exhibited greater homogeneity than urban and teaching hospitals. EHR functions emphasized in stage 1 meaningful use are spread throughout the scale.Discussion Stronger homogeneity among small, rural, and non-teaching hospitals may be driven by greater reliance on vendors and less variation in the types of care they deliver. Stage 1 meaningful use is likely changing how hospitals sequence EHR adoption—in particular, by moving clinical guidelines and medication computerized provider order entry ahead in sequence.Conclusions While there is a common sequence underlying adoption of EHR functions, the degree of adherence to the sequence varies by key hospital characteristics. Stage 1 meaningful use likely alters the sequence. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the American Medical Informatics Association Oxford University Press

Sequencing of EHR adoption among US hospitals and the impact of meaningful use

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References (16)

Publisher
Oxford University Press
Copyright
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
ISSN
1067-5027
eISSN
1527-974X
DOI
10.1136/amiajnl-2014-002708
pmid
24853066
Publisher site
See Article on Publisher Site

Abstract

AbstractObjective To examine whether there is a common sequence of adoption of electronic health record (EHR) functions among US hospitals, identify differences by hospital type, and assess the impact of meaningful use.Materials and methods Using 2008 American Hospital Association (AHA) Information Technology (IT) Supplement data, we calculate adoption rates of individual EHR functions, along with Loevinger homogeneity (H) coefficients, to assess the sequence of EHR adoption across hospitals. We compare adoption rates and Loevinger H coefficients for hospitals of different types to assess variation in sequencing. We qualitatively assess whether stage 1 meaningful use functions are those adopted early in the sequence.Results There is a common sequence of EHR adoption across hospitals, with moderate-to-strong homogeneity. Patient demographic and ancillary results functions are consistently adopted first, while physician notes, clinical reminders, and guidelines are adopted last. Small hospitals exhibited greater homogeneity than larger hospitals. Rural hospitals and non-teaching hospitals exhibited greater homogeneity than urban and teaching hospitals. EHR functions emphasized in stage 1 meaningful use are spread throughout the scale.Discussion Stronger homogeneity among small, rural, and non-teaching hospitals may be driven by greater reliance on vendors and less variation in the types of care they deliver. Stage 1 meaningful use is likely changing how hospitals sequence EHR adoption—in particular, by moving clinical guidelines and medication computerized provider order entry ahead in sequence.Conclusions While there is a common sequence underlying adoption of EHR functions, the degree of adherence to the sequence varies by key hospital characteristics. Stage 1 meaningful use likely alters the sequence.

Journal

Journal of the American Medical Informatics Association – Oxford University Press

Published: Nov 22, 2014

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