Rural Hospitals Struggle With EHRs, Meaningful Use

Since the passage of the HITECH Act in 2009, meaningful use has helped encourage numerous health care organizations to integrate electronic health records (EHRs) into their practices. At the same time, it’s caused headaches among providers and hospitals who have found the timeline for adoption to be too rapid, or who lack the resources to efficiently and effectively make the transition to the advanced use of EHRs. To the latter point, the results of a new study published in the Journal of the American Medical Informatics Association (JAMIA) have led some advocates to worry about a “digital divide” between hospitals that are using EHRs in advanced ways and those that are not. As Fierce Healthcare first reported, the authors, led by the University of Michigan’s Julia Adler-Milstein, found that some hospitals—particularly those that serve rural and low-income patients—are not fully utilizing the record systems.

Digging deeper into the study’s results, the researchers found that the majority of hospitals—80.5 percent—had in place at the minimum “a basic EHR system,” which represents an increase over 2014 numbers. But fewer hospitals (37.5 percent) “adopted at least eight (of 10) EHR data for performance measurement functions, and 41.7 percent adopted at least eight (of 10) patient engagement functions,” per the researchers. The gap was particularly stark with critical access hospitals, defined by the American Hospital Association as “rural community hospitals that receive cost-based reimbursement,” as the study’s authors found they were even less likely to be using EHRs in advanced ways. Such hospitals tend to disproportionately serve low-income patients. “This is concerning, because EHR-enabled performance measurement and patient engagement are key contributors to improving hospital performance,” the researchers explained.

Notably, over on Capitol Hill, the challenges that some health care organizations are experiencing with meaningful use have not gone unnoticed. As we reported earlier this summer, Rep. Michael Burgess (R-TX) and Rep. Debbie Dingell (D-MI) have introduced legislation that would help to relax meaningful use standards. Specifically, the bill would give the HHS Secretary more flexibility in setting those standards, and would thus help HHS staff to save time and resources that would ordinarily be spent on hardship waiver-request processing. The Burgess-Dingell legislation was discussed during a July Energy and Commerce Committee hearing on strategies for strengthening Medicare, during which some advocates expressed their support for it.

Click here to read the Fierce Healthcare article on the EHR utilization study results.

Click here to read the JAMIA abstract of the EHR adoption study (full study requires registration). 


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