BOSTON – Less than 2 percent of U.S. hospitals have enough healthcare information technology systems in place to improve how they deliver care, according to a study in the March 26 online edition of the New England Journal of Medicine.
The study comes as hospitals prepare to cash in on more than $1 million a year in Medicare and Medicaid money in the stimulus package if they can show meaningful use of healthcare IT. "Meaningful use of healthcare IT" has yet to be defined by the Department of Health and Human Services, and payment of bonuses isn't expected until 2011. After 2015, hospitals will face penalties for not having healthcare IT in place.
Experts are also warning that even as hospitals may scramble to upgrade their healthcare IT adoption, there are not enough transitional consultants to help them upgrade.
The survey of nearly 3,000 hospitals, conducted with the help of the American Hospital Association, shows that less than 2 percent use comprehensive electronic health records (EHRs), and about 8 percent use a basic EHR in at least one care unit that includes physician or nurse notes. The findings are the first reliable estimates of the prevalence of HIT adoption in U.S. hospitals, the study's authors said.
"HIT adoption levels are abysmally low in American hospitals. We have a long way to go to achieve a healthcare system that is fully electronic," said lead author Ashish Jha, MD, an associate professor at the Harvard School of Public Health. He said the biggest barrier to adoption is cost.
John Glaser, vice president and CIO at the Partners HealthCare System, said healthcare IT adoption is "hard work" that requires behavior change, workflow adjustments, leadership, commitment, skilled vendors and implementers. "It's not a trivial undertaking," he said.
Glaser said he's not surprised by the results of the survey, "given the daunting nature of the task." The stimulus package is encouraging as a start to help hospitals fund adoption, he added.
David Blumenthal, MD, director of the Institute for Health Policy and a senior author of the study, has been appointed National Coordinator for Health Information Technology, replacing Robert Kolodner in mid-April.
"Despite the promise that HIT holds for better health, the accumulating evidence shows that many of those who deliver care have yet to be convinced," he said. "This survey continues to make the case for why the federal government needs to step in and exercise its fiscal and policy muscle to spur adoption."
Jha conducted the study with researchers at the Institute for Health Policy and the Biostatistics Center at Massachusetts General Hospital, Brigham and Women's Hospital, the VA Boston Healthcare System and the Department of Health Policy at George Washington University. The study was funded by The Robert Wood Johnson Foundation and the Office of the National Coordinator for Health Information Technology.
The survey follows one released in 2008 by the same group of authors that showed that only 17 percent of doctors are using EHRs and only 4 percent use full EHRs.
