Paper Beats Electronic Records at Small Hospitals

Size matters when it comes to hospitals’ adoption of electronic health records -- and so does location, according to a study in the journal Health Affairs.

The title of the study says it all: “Small, Nonteaching, and Rural Hospitals Continue to be Slow in Adopting Electronic Health Record Systems.” Researchers from Princeton, Harvard and the American Hospital Association conducted the study using data from the association’s annual hospital survey.

According to the study abstract, the percentage of hospitals with at least a basic EHR rose from 15.1 percent in 2010 to 26.6 percent in 2011, following the introduction of federal financial incentives for achieving meaningful use of the health IT systems. The proportion of hospitals that had implemented a “comprehensive” system increased from 3.6 percent to 8.7 percent.

Additionally, 18.4 percent of hospitals had achieved meaningful use in at least one clinical unit in 2011, with 11.2 percent meeting those standards across all units.

But “gaps in rates of adoption of at least a basic record system have increased substantially over the past four years based on hospital size, teaching status and location,” according to the abstract.

According to a report in InformationWeek Healthcare, the study is the “first nationally representative survey of hospital EHR system adoption since the federal incentive programs began.” It showed the gap in EHR adoption between large and small hospitals had grown from 15 percent in 2010 to nearly 22 percent last year.

The study’s authors urged policymakers to “redouble their efforts among hospitals that appear to be moving slowly and ensure that policies do not further widen gaps in adoption.”

They also called for a “more robust infrastructure” for the exchange of health information and “possibly a special program for the sizable minority of hospitals that have almost no health information technology at all.”

The full article is available to Health Affairs subscribers.