BOSTON – Although few U.S. hospitals have a comprehensive electronic health records system in place, many have parts of an EHR - which could help spur adoption faster than data may suggest, says a New England Journal of Medicine article.

According to a survey of all acute care hospital members of the American Hospital Association, with 63.1 percent of hospitals responding, only 1.5 percent of those hospitals have a comprehensive EHR system (present in all clinical units), 7.6 percent have a basic system (present in at least one clinical unit) and 17 percent have a computerized provider-order entry for medications.

With such low adoption rates, the article says, "policymakers face substantial obstacles to the achievement of healthcare performance goals that depend on health information technology." 

According to the article, using a definition that requires the presence of functions for physicians' notes and nursing assessments, information systems in more than 90 percent of U.S. hospitals do not even meet the requirement for a basic electronic-records system.

The survey found hospitals are using many functionalities that underlie an EHR system such as laboratory and radiological reports, radiological images, medication lists and some decision-support functions. Hospitals also reported plans to upgrade their systems with CPOE, physicians' notes and nursing assessments.

According to those surveyed, financial barriers far outweigh physician resistance for adoption, which the article suggests is why rewarding hospitals for their use could be effective.

Another barrier cited was interoperability, with few hospitals having the ability to communicate with each other or physician offices and few health information exchanges in place.

The article concludes, "critical strategies for policymakers hoping to promote the adoption of electronic health records by U.S. hospitals should focus on financial support, interoperability and training of information technology support staff."