HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Is There an App for That? Electronic Health Records (EHRs) and a New Environment of Conflict Prevention and Resolution

Katsh discusses the new problems that are a consequence of a new technological environment in healthcare, one that has an array of elements that makes the emergence of disputes likely. Novel uses of technology have already addressed both the problem and its source in other contexts, such as e-commerce, where large numbers of transactions have generated large numbers of disputes. If technology-supported healthcare is to improve the field of medicine, a similar effort at dispute prevention and resolution will be necessary

Equity in the Digital Age: How Health Information Technology Can Reduce Disparities

While enormous medical and technological advancements have been made over the last century, it is only very recently that there have been similar rates of development in the field of health information technology (HIT).This report examines some of the advancements in HIT and its potential to shape the future health care experiences of consumers. Combined with better data collection, HIT offers signi?cant opportunities to improve access to care, enhance health care quality, and create targeted strategies that help promote health equity. We must also keep in mind that technology gaps exist, particularly among communities of color, immigrants, and people who do not speak English well. HIT implementation must be done in a manner that responds to the needs of all populations to make sure that it enhances access, facilitates enrollment, and improves quality in a way that does not exacerbate existing health disparities for the most marginalized and underserved

Market factors and electronic medical record adoption in medical practices

Background: Previous studies identified individual or practice factors that influence practice-based physicians’ electronic medical record (EMR) adoption. Less is known about the market factors that influence physicians’ EMR adoption. Purpose: The aim of this study was to explore the relationship between environmental market characteristics and physicians’ EMR adoption. Methods: The Health Tracking Physician Survey 2008 and Area Resource File (2008) were combined and analyzed. Binary logistic regression was used to examine the relationship between three dimensions of the market environment (munificence, dynamism, and complexity) and EMR adoption controlling for several physician and practice characteristics. Results: In a nationally representative sample of 4,720 physicians, measures of market dynamism including increases in unemployment, odds ratio (OR) = 0.95, 95% confidence interval (CI) [0.91, 0.99], or poverty rates, OR = 0.93, 95% CI [0.89, 0.96], were negatively associated with EMR adoption. Health maintenance organization penetration, OR = 3.01, 95% CI [1.49, 6.05], another measure of dynamism, was positively associated with EMR adoption. Physicians practicing in areas with a malpractice crisis, OR = 0.82, 95% CI [0.71, 0.94], representing environmental complexity, had lower EMR adoption rates. Practice Implications: Understanding how market factors relate to practice-based physicians’ EMR adoption can assist policymakers to better target limited resources as they work to realize the national goal of universal EMR adoption and meaningful use

Electronic Health Records and Rural Hospitals

Nearly 20% of the U.S. population lives in rural areas and are not resistant to many of the U.S. healthcare challenges such as cost, quality, and access. In fact, the distinguishing cultural, social, economic, and geographic traits which characterize rural America place rural populations at greater risk for many diseases and health disorders. Like those in urban settings, people from rural areas have been affected by the use of health information technology, where treatment is now data-intensive, and there are more options and greater expectations of quality and accountability. Due to cost, geographic and social traits, and the digital divide between urban and rural communities, the rapid changes in health information technology have not affected rural communities in the same way they have affected more central and populous areas. The irony is that rural communities are often the ones with the poorest health outcomes and most in need of assistance. Implementation of EHRs is more difficult in rural areas, in comparison to urban ones due to certain barriers. But, with a little more time and effort on behalf of hospital staff, policy makers, and patients, these rural areas can overcome the barriers of implementation and succeed in meeting the meaningful use requirements. Ultimately, this will transform the quality of care within rural healthcare facilities and furthermore improve the health outcomes of rural patients

Improvement in the Rate of Full Implementation of Electronic Advanced Directives in Acute Care Hospitals after the HITECH Act

This report reviews the improvement in accessibility of POLST in United States hospitals since the implementation of the HITECH Act in 2009. An analysis and compilation of available information was conducted from all US acute care hospitals responding to the Information Technology Supplement to the annual American Hospital Association (AHA) survey. The survey was voluntary including non-members of the association. The total number of hospitals that participated in 2009 were 2903 while 2782 in 2018. From the results, there was slight increase in hospital beds in 2019 compared to 2018. In 2009, 64% of the hospitals were private nonprofit, 25% government hospitals and 11% were private for-profit hospitals while in 2018, most were private nonprofit at 66%, government at 22% and private for profit 12%. The report showed a significant improvement (42%) in the hospitals capability to fully implement advanced directive (DNR) across every unit by 2018. The study shows smaller hospitals recorded much improvements in DNR by 2018 as opposed to larger hospitals. This was similar to government and For-profit hospitals unlike nonprofit hospitals that realized insignificant improvements. Besides a hospitals intent to apply for CMS payments in 2009 had no significant effect in DNR availability in 2018. It was found that HITECH has greatly enhanced the availability of POLST information especially for emergency situations

Capturing The Financial Benefits Of Electronic Medical Record Investments In The Small Medical Practice

This study examines the challenges faced by the small medical practice (1-2 providers) in capturing the financial benefits of investing in Electronic Medical Records (EMR). In particular the paper focuses on three key elements of the process: (A) A theoretical framework that explores the underlying principles that drive the variation in benefit capture and ROI associated with EMR investments; (B) The risk to reward levels that set an appropriate cost of capital for investments of this type; and (C) An understanding (and limit) of financial exposure during EMR projects

Electronic Health Record Implementation Strategies for Decreasing Healthcare Costs

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training logs, activity records, and cost information. Methodological triangulation was used to validate the creditability and interpretation of the data in transcribing themes. Three themes emerged from the analysis of study data: implementation of EHRs, costs of implementing EHRs, and perceived usefulness of EHRs. Participants indicated that the implementation of EHRs depended on motivation, financial cost, and the usefulness of EHRs relating to training that reflected user-friendliness. The implications of this study for social change include the potential to lower the cost and improve the efficiency of healthcare for patients. The use of EHR systems could enhance the quality of care delivered to patients through improved accessibility, elimination of duplicative tests, and retrieval of accurate patient information. The use of EHRs can lead to a comprehensive preventative healthcare system resulting in a healthier environment

Sorting out EHR adoption and assimilation in the Meaningful Use incentive program in Hawaii

Both widespread adoption and meaningful assimilation are needed to achieve the full benefits of EHRs. In the U.S. the HITECH Act and its Meaningful Use (MU) program have stimulated EHR adoption to historically high levels. Questions remain about program efficacy and possible unintended consequences. In this paper, we report our analysis of Meaningful Use attestation data for the period 2011-2014 in the State of Hawai’i. Findings indicate that the MU program primarily stimulated deeper assimilation of EHRs among existing adopters in 2011, mostly in large practice groups. In subsequent years, EHR adoption and assimilation, evidenced by MU attestation, increased then peaked among small, independent practices. In the final study year, attestation rates dropped for small practices, although only one third of eligible providers have attested, while attestation among larger practices remained steady as this group shifted to the next MU stage. Findings suggest small practices, particularly primary care and rural practices, continue to face high barriers to meaningful EHR adoption and assimilation. Findings suggest better targeted policies and incentives may be needed to keep this promising program on track.