How are hospitals actually using their EHRs? See the answer, charted.

Read Advisory Board's take: How health systems can make the greatest use of their EHR data

The vast majority of U.S. hospitals use EHR systems, but exactly how hospitals use their EHRs varies, according to a new report from the Office of the National Coordinator for Health IT (ONC).

About the report

For the report, ONC used data from the American Hospital Association's IT surveys to determine how non-federal acute-care hospitals utilized EHR data between 2015 and 2017. To determine EHR data use, ONC relied on a set of 10 measures that it notes "describe hospital processes for leveraging data within their EHR to inform clinical practice."

How hospitals use EHR data

The data showed 94% of hospitals were using EHRs in 2017, up from 87% in 2015. The report found most hospitals used EHRs to support quality improvement efforts, monitor patient safety, and monitor organization performance, but hospitals' use of the other seven measures ONC examined varied.

In addition, the data show EHR use varied by hospital setting. For example, the data show in 2017, rural hospitals on average used their EHRs for 5.5 out of the 10 measures ONC examines, compared with an average of 7.7 among urban hospitals.

Similarly, small hospitals—which ONC defined as hospitals with less than 100 beds—on average used fewer of the 10 examined EHR data use processes than medium-to-large hospitals, which ONC defined as hospitals with more than 100 beds.

State and local government hospitals also had fewer EHR data use processes on average than both for-profit and nonprofit hospitals.

In addition, hospitals within a hospital system had higher rates of EHR use than hospitals outside a hospital system.

"The trend towards greater use of EHR data is likely to continue with the forthcoming implementation of the 21st Century Cures Act," the report stated. "Thus, understanding how hospitals are currently using their EHR data is important as policy initiatives seek to incentivize hospitals to use their EHR data for performance and population health management" (Harris, Healthcare IT News, 4/17; Kim Cohen, "Transformation Hub," Modern Healthcare, 4/17; Office of the National Coordinator for Health IT report, April 2019).

Advisory Board's take

Greg Kuhnen, Senior Director, Health Care IT Advisor

This latest data from ONC supports the continuation of a welcome trend: After the forced march to implement EHRs during the meaningful use era, hospitals are increasingly putting their data to work improving quality, identifying high-risk patients, finding operational efficiencies, and informing strategy.

However, the report also highlights the disparity between the 'haves' and 'have nots' in terms of putting these analytics to use. Hospitals that are larger, urban, academic, or part of a larger system were more likely to put their data to work advancing broader initiatives than smaller, rural, or independent hospitals. Seen in the broader context, this makes sense. Technological advancements of all kinds tend to favor systems with the scale and resources necessary to invest the people and funds to use them.

Yet that doesn't mean that the data from EHRs will—or should—make the playing field between these systems less even. While new technologies and data-driven decisions may give large systems an advantage, systems at any scale can make better use of the data and technologies they have. In our surveys and conversations with members, we've repeatedly found the biggest barriers to data-driven decision making are rooted in culture and organizational structure. Changing this culture takes time and a consistent focus from the leadership team, but we've identified several tactics that can help. These include:

  • Starting small. Early on, it's best to tackle narrower domains decisively and to use those successes as a launching point for broader analytics ambitions.
  • Empowering front-line decision makers. Analytics should be a tool at every level of the organization. Therefore, organizations should support front-line decision makers with access to data and expert support.
  • Focusing on data governance. High quality, well-documented data is the single biggest driver of value for analytics-enabled improvements of all kinds.

To learn more about how you can turn your data into actionable analytics, view our resource library on data governance. Then, to learn more about how you can work with your EHR vendor to build out the capabilities you need to drive deeper value, register for our webconference tomorrow at 12 pm ET on How to Negotiate Win-Win Contracts.

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