Only 1.5% of nonfederal U.S. hospitals use a comprehensive electronic health record system, according to HHS-funded researchers in a report released by the New England Journal of Medicine and mirroring preliminary survey results released by the same researchers this past November.
Lead author Ashish Jha, an associate professor at the Harvard School of Public Health and a staff physician at staff physician at Veterans Affairs and Brigham and Women’s hospitals in Boston, said in a news conference that just 7.6% of hospitals had a “basic” EHR that included the capability to record and store physician and nursing notes. The survey found that 10.9% of hospitals had a basic system without those clinical note-keeping functions.
“Very few hospitals in America have a comprehensive electronic health record,” Jha said. In addition, Jha said, “We didn’t get into effective use of these technologies. And we don’t have information right now with the notion of sharing data with other providers. Just because they have these systems doesn’t mean they are sharing that information with other doctors or hospitals down the street.”
That said, not all was gloom and doom. For one thing, if data from the VA hospitals, which were gathered but excluded from the final survey totals, were added back in, the comprehensive EHR adoption numbers would nearly double to 2.9% and the national numbers for the basic adoption rates would be driven up as well.
“All VA hospitals now have adoption of comprehensive medical records,” said Jha, who is serving as VA advisor. “There are as many VA hospitals with comprehensive medical records as there are non-VA hospitals (with those systems) if you look at it numerically.”
Also, he said, “There is no suggestion here that 90% of hospitals don’t have a computer in the hospital,” Jha said. In fact, some component parts of an EHR are in widespread use. For example, the survey found that 75% of hospitals surveyed reported having electronic lab and radiology systems.
What hospitals don’t have is “a constellation of functionalities” that help doctors and nurses provide the best care possible, Jha said, but the relatively high levels of adoption of some components “suggests we have a good place to start.”
Information about the study was under embargo until Wednesday, but its authors and other healthcare luminaries were available to reporters via a telephone conference Tuesday. One of those was David Blumenthal, the physician founder of the Institute for Health Policy, who spoke briefly about the research report and an article he had written for the New England Journal of Medicine on the federal role for health IT promotion.
Last week, Blumenthal was named as President Barack Obama’s choice to be the national coordinator for health information technology. Blumenthal said he will take over the post in mid-May.
Speaking of the impact the American Recovery and Reinvestment Act of 2009 would have on healthcare information technology, Blumenthal said that for physicians, “This whole project was conceived by the Congress as a building block as a pillar of healthcare reform.”
“One of the key elements is to support behavior change,” he said. “IT is one important and ultimately critical way to do that. I think it would be wrong to see it as a technology that can be adopted on its own, but as a technology to support that.”
The study and Blumenthal’s article are scheduled to appear Thursday in the journal’s online edition.
