'Post-EHR era'? Not so fast

Nationwide EHR adoption is in reach, but will require attention to small and rural hospitals
By Mike Miliard
10:17 PM
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Many have commented these past couple years (including your humble correspondent) about the "post-EHR era." In the half-decade since Stage 1 meaningful use, the story goes, health providers all now have their electronic health records installed, humming and finely-tuned and are now turning their attention to newer and more advanced species of IT - to better prepare them for the realities of care coordination and analytics-driven population health management.

But a recent study in Health Affairs suggests the truth is a bit more complicated than that.

In "Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist," researchers show how EHRs may not be quite as widespread and commonplace as some might think.

Some 75 percent of U.S. hospitals now have "at least a basic EHR system" in place, the authors write - which is better than the 59 percent that could say the same back in 2013, but perhaps not as ubiquitous as many would assume nowadays.

Unsurprisingly, those facilities without that basic functionality tend to be small and rural, the researchers point out. That could be a problem, now that the "carrot" era of meaningful use is now over.

"While EHR adoption has increased steadily since 2010," according to the study, "it's unclear how providers that haven't yet adopted will fare now that federal incentives have converted to penalties."

And while there have been some encouraging signs over the past two years - such as a marked increase in hospitals' ability to meet core Stage 2 MU criteria (40.5 percent of hospitals, up from 5.8 percent in 2013) - that's undoubtably still much lower than the Centers for Medicare & Medicaid Services would've liked to see.

Meanwhile, providers of all sizes and levels of IT maturity continue to grapple with an array of challenges.

"Hospitals most often reported up-front and ongoing costs, physician cooperation and complexity of meeting meaningful-use criteria as challenges," the authors write. "Our findings suggest nationwide hospital EHR adoption is in reach but will require attention to small and rural hospitals and strategies to address financial challenges, particularly now that penalties for lack of adoption have begun."

Read the full report at Health Affairs here.

See also:

Where are we headed, post-HITECH?
Growth seen for non-clinical IT in 'post-EHR' world
New to-do lists loom for 'post-EHR era'
Chilmark report sees HIEs moving into 'post-EHR era'