EHR Adoption: US Hospitals, Caring for Poor; Role of State, Federal Initiatives; and Meaningful Use
Robert Wood Johnson Foundation-funded Report
Health Information Technology in the United States:
On the Cusp of Change 2009
(See Web sites and downloads below.)
Health Information Technology in the US: On the Cusp of Change 2009, published Oct-Nov 2009, is the third report of a series produced since 2006. The “State of the Field” report consists of five articles on EHR to “share the lessons of the ONCHIT more broadly and review what is known about the state of EHR adoptions and its implications for improving health care quality.” It was jointly produced by Robert Wood Johnson Foundation, George Washington University Medical Center, and Institute for Health Policy at Massachusetts General Hospital and Partners Health System.
Chapter 1: Beyond the Doctor’s Office: Adoption of Electronic Health Records in U.S. Hospitals.
Ashish K. Jha, M.D., M.P.H., Catherine M. DesRoches, Dr.P.H., Eric G. Campbell, Ph.D., Karen Donelan, Sc.D., Sowmya R. Rao, Ph.D., Timothy G. Ferris, M.D., M.P.H., Alexandra Shields, Ph.D., Sara Rosenbaum, J.D.
Chapters 1 and 2 are based on a 2008 survey conducted in conjunction with American Hospital Association to survey all acute care general medical/surgical member hospitals in US. While results show under 10% of hospitals have either comprehensive EHR (<2%) or basic (<8%), about 8 out of ten hospitals offered hospital-wide views of lab and radiology reports and radiology images. One out of five had hospital-wide computerzied order entry and clinical decision support. Earlier article based on this survey was published in New England Journal of Medicine in March 2009. Finances were cited as leading cause of non-implementation.
Chapter 2: Adoption of Electronic Health Records Among Hospitals that Care for the Poor: Early Evidence of a New Healthcare Digital Divide?
Ashish K. Jha, M.D., M.P.H., Catherine M. DesRoches, Dr.P.H., Eric G. Campbell, Ph.D., Alexandra Shields, Ph.D., Paola D. Miralles, B.S., Jie Zheng, Ph.D., Sowmya R. Rao, Ph.D., and Sara Rosenbaum, J.D.
This article was published online Oct 26, 2009 on HealthAffairs.org, and examines the relationship between poor hospital populations and rate and value of EHR implementation.
Chapter 3: State Roles in the Advancement of Health Information Technology.
Steffanie J. Bristol, B.S., Paola D. Miralles, B.S.
State governments adopted 168 legislative measures about HIT between 2005 and 2008 with topics including ”planning and oversight, HIE, advacning adoption and implementation, funding, and privacy protection and security.” States have an important but fiscal-challenged role in current economic environment.
Chapter 4: Recent Federal Initiatives in Health Information Technology.
Melissa M. Goldstein, J.D., Lee Repasch, M.A., and Sara Rosenbaum, J.D.
Chapter 4 examines impact of “meaningful use,” “certified EHR,” and financial incentives on caring for vulnerable populations.
Chapter 5: Potential Implications of Widely Adopted Meaningfully Used HIT: Is Quality Measurement and Reporting About to Take Flight?
Michael W. Painter, J.D., M.D.
Chapter 5 focuses on impact of EHR adoption and public reporting of quality data. “This technology may make clinical data extraction both efficient and inexpensive, which would facilitate large-scale clinical performance measurement efforts.”
Health Information Technology in the United States:
On the Cusp of Change 2009 – Web Page
Executive Summary Full Report
RWJF Release on Digital Divide
Robert Wood Johnson Foundation HIT Reports
Health IT in the US, 2008 Report Page
Health IT in the US, 2006 Report Page
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