RWJF: Hospitals increasingly adopt electronic health records

Hospitals met standards for data collection, fell short on data exchange

Topics: Information Technology, Electronic Medical Records Strategy, Meaningful Use, IT Infrastructure

July 10, 2013

Providers are rapidly adopting health IT, but significant barriers remain to widespread use of the technology, according to several new studies published in the journal Health Affairs on Monday.

Hospital EHR adoption tripled between 2010 and 2012

A new Robert Wood Johnson Foundation (RWJF) report found that 44% of hospitals used basic electronic health record systems in 2012, compared with 27% in 2011.

Researchers found that the overall rate of hospital EHR adoption in 2012:

  • Was 33.5% for rural hospitals, a 257% increase from 2010; and
  • Was 47.7% for urban hospitals, a 180% increase from 2010.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.

According to the report, about 42% of hospitals had all of the necessary EHR functions to meet Stage 1 of the meaningful use program, compared with 4.4% in 2010. Only 5% of hospitals met all 16 objectives for Stage 2 of the program, but 63% said they met 11 to 15 of the required functionalities.

Report on health information exchange adoption

A second RWJF report found that while 42% of hospitals have met federal standards for electronic data collection, only 5% have met the same standards for data exchange. 

The report found that 75% of all hospital services had a health information exchange in 2012, but only 30% of community hospitals and 10% of physicians reported participating in a health data exchange.

Respondents listed several barriers to health information exchange adoption, including:


  • Financial sustainability;
  • Privacy and confidentiality concerns;
  • Government policies and mandates;
  • Technical problems;
  • Stakeholder competition concerns; and
  • Accuracy of patient data.

The authors recommended that several steps be taken to boost health data exchange use, such as:


  • Including more health information exchange requirements in Stage 3 of the meaningful use program;
  • Boosting efforts to engage payers in health data exchange by determining potential barriers and designing appropriate policies; and
  • Having the Office of the National Coordinator for Health IT emphasize the need for states to identify sustainable business models related to data exchange.

Report on adoption of e-prescribing

Meanwhile, a report by Project HOPE found that incentives under the Medicare Improvements for Patients and Providers Act (MIPPA) greatly increased the number of health care providers who use electronic prescribing technology.

Researchers found that the average number of providers who began e-prescribing for the first time increased from 1,437 per month to 6,346 per month in the period following the passage of MIPPA.

Additionally, the report found that:


  • Incentives accounted for the addition of about 90,000 new e-prescribers after MIPPA's passage;
  • Nearly 40% of active prescribers at the end of 2010 had adopted the technology because of the incentives; and
  • Physicians who already were using e-prescribing technology increased the volume of e-prescriptions by 10% following MIPPA's passage (Conn, Modern Healthcare, 7/8 [subscription required]; DesRoches et al., Health Affairs, July 2013; Goedert, Health Data Management, 7/8; Gorman, "Nation Now," Los Angeles Times, 7/8; Lowes, Medscape , 7/8; Perna, Healthcare Informatics, 7/8; Thompson, HealthDay/U.S. News & World Report, 7/8).

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