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Hospital EHR Adoption of Basic Systems Tops 83%, CEHRT 96%

Most hospitals are using certified EHR technology, but certain kinds of hospitals still lag behind in EHR adoption and use.

By Kyle Murphy, PhD

Certified EHR technology is in place at most hospitals with basic EHR technology adoption also reaching an all-time high, according to new data published by the Office of the National Coordinator for Health Information Technology.

The latest data brief made available on the HealthIT.gov Dashboard puts the percentage of hospitals with CEHRT at 96 percent in 2015, down nearly a full percentage point from 2014's figure of 96.9 percent. Hospital adoption of basic EHR technology, meanwhile, rose from 75.5 percent in 2014 to 83.8 percent in 2015. All told, since 2008 hospital adoption of the latter rose by nearly nine times, from 9.4 percent to the current figure.

Leading the way in adoption were Maryland (95%), Nevada (94%), Washington (94%), Wyoming (94%), Massachusetts (93%), Virginia (93%), Utah (93%), Arkansas (90%), and New Mexico (90%).

This ONC data once again requires clarification as to the different between the types of EHR technology. A handy chart accompanying the data brief shows how basic EHR with clinician notes stacks up to comprehensive EHR. Other than supporting advanced directions, the former does everything the latter does for electronic clinical information.

As for computerized provider order entry, basic EHR with clinician notes only satisfies the medication component whereas comprehensive EHR includes information on lab reports, radiology tests, consultation requests, and nursing orders on top of medications.

Lastly, in the area of results management, basic EHR allows for the viewing of lab and radiology reports and viewing diagnostic results. The reporting of results includes viewing consultant reports, diagnostic test images, and radiology images.

Clinical decision support is only a feature of comprehensive EHR technology.

Comparison of EHR system types by functionality

Over same span of time, rural and critical access hospitals made headway in basic EHR system adoption. Since 2011, basic EHR adoption roses from 22 percent to 81 percent in 2015, jumping by as many as 20 percentage points year-over-year. Basic EHR adoption at rural hospitals saw a similar trajectory, moving from 22 percent in 2011 to 80 percent in 2015. The largest year-over-year gain belonged to critical access hospitals that grew its adoption percentage from 20 percent in 2011 to 80 percent in 2015.

Meanwhile, other categories of hospitals have plenty of ground to make up, especially psychiatric hospitals whose basic EHR adoption figure was 7 percent in 2008 and doubled to 15 percent by 2015. Children's hospitals have less ground to make up on general medicine hospitals, but it's still substantial. In 2008, 10 percent of children's hospitals were using a basic EHR, which quintupled to 55 percent in 2015. Conversely, general medicine hospital basic EHR adoption grew from 12 percent to 84 percent over the same period of time.

On a national level, hospital basic EHR adoption rates exceeded 65 percent across all states in 2015 compared to basic EHR adoption rates at or below 22 percent back in 2008. State-level hospital adoption of Basic EHR systems was 80 percent or higher in 35 states in 2015, a step up from 2011 when no states had rates at 80 percent or higher.

As for hospital EHR use, advanced functionality use has shown steady growth over the last seven years. Eight out of 10 hospitals (84%) adopted EHRs with advanced levels of functionality above basic EHRs without clinician notes in 2015. Despite the 11-percent increase in EHR adoption with advanced functionalities between 2014 and 2015, a 42-percent decrease emerged in the use of less advanced EHR systems.

"Realizing the full value of widespread EHR adoption will require focusing on these new challenges and it will be important to shift our focus from hospital adoption of EHRs to monitoring progress in these new areas," the authors of the brief conclude. "This would not only include hospitals' interoperability but also examining health IT adoption and interoperability across additional settings including long-term care providers and behavioral health care providers, and beyond the care continuum, such as social services and public health."





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