Certified EHR technology now widely used at U.S. hospitals

Nearly all of the country’s hospitals have adopted certified electronic health records, according to new survey data released May 31 by the Office of the National Coordinator for Health Information Technology.

At least one IT professional organization commended the results of the survey, but noted that other data results suggest that the industry has a ways to go in improving its ability to share patient data among providers involved in the care process.

In fact, results of the survey show the industry has a long way to go in sharing and then using from other healthcare organizations in treating patients—only a minority say they use patient information from outside their organization in treating patients.

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Based on the American Hospital Association IT Supplement to the AHA annual survey, the adoption rate of certified EHRs has increased from almost 72 percent in 2011 to 96 percent in 2015.

“As we kick off the 2016 ONC Annual Meeting today, these data showing nearly universal adoption of certified electronic health records by U.S. hospitals are an indication of how far we have come for clinicians and individuals since the HITECH Act was passed,” said National Coordinator for Health IT Karen DeSalvo, MD.

Last year, 84 percent of hospitals adopted at least a basic EHR system, representing a nine-fold increase since 2008. ONC defines basic EHR adoption as a minimum use of core functionality determined to be essential to an EHR system, including clinician notes. The set of EHR functions must be implemented in at least one clinical unit to be considered basic EHR adoption.

While small, rural, and critical access hospitals continue to have significantly lower basic EHR adoption rates compared with all hospitals, ONC notes that the new data show that adoption rates for these hospitals has increased significantly. Since 2014, small and rural hospitals increased their adoption of basic EHRs by at least 14 percentage points and CAHs increased their adoption of basic EHRs by 18 percentage points. Currently, about eight out of 10 small, rural, and CAHs have adopted a basic EHR.

“Since enactment of the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH), hospitals, health systems and physician practices have made considerable progress adopting EHRs,” says Marc Probst, CIO of Intermountain Healthcare and board chair of the College of Healthcare Information Management Executives (CHIME).

In addition, the data reveal there have been increases in health data sharing among hospitals, with more than 85 percent of hospitals sending key clinical information electronically in 2015, while 82 percent of hospitals electronically exchanged lab results, radiology reports, clinical summaries or medication lists with ambulatory care providers or hospitals outside their organization.

“We are pleased to see the increase since 2011 through 2015 of hospitals using EHRs,” adds Mari Rose Savickis, vice president of federal affairs for CHIME. “The next step will be ensuring that federal policies are as supportive as possible for providers trying to make it in a world that is increasingly being driven by quality improvement, outcomes and value.”

CHIME is continuing to ask for changes in the meaningful use program to give hospitals a greater chance for success,” Savickis says.

Last year, approximately half of hospitals had health information electronically available from providers outside their systems, growing five percentage points from 2014. Further, about half of hospitals report they often or sometimes use patient information they receive electronically from providers outside their systems.

“The flow of health information is really critical to many of our national priorities,” such as the precision medicine and cancer moonshot initiatives, said Vindell Washington, MD, principal deputy national coordinator for HIT, during opening remarks at the ONC Annual Meeting. “Interoperability is also critical to public health and clinical research.”

Still, about one-third of hospitals (36 percent) surveyed indicated that their providers rarely or never use patient health information received electronically from outside their hospital system when treating their patients. Another one-third of hospitals said their providers sometimes use patient health information received electronically from outside their hospital system when treating their patients. And, less than one-fifth of hospitals reported their providers often use that type of patient health information when treating their patients.

The most common reason (53 percent) cited by surveyed hospitals for not using patient health information received electronically from outside providers is that the information is not available to view within the EHR as part of clinicians’ workflow.

Key issues still need to be addressed to facilitate data sharing, Probst and CHIME contend.

“Some foundational issues must be addressed before we can fully harness the power of health IT,” Probst says. “It’s time to find a way to accurately identify patients wherever and whenever they seek care. A national patient ID solution will not only improve patient safety…but it will accelerate efforts to achieve interoperability and information exchange.”

”We also believe that tighter standards will help drive better data exchange,” Savickis says. “Exchange rates are increasing—the next question becomes what is being exchanged, and how is that exchange driving better outcomes for patients?”

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