The survey did not assess how effectively hospitals were using electronic records or whether they could share information with other offices. “Just because hospitals have these systems doesn’t mean they are sharing the information with offices down the street,” said Ashish Jha, a physician at Harvard Medical School and lead author on the study, at the press conference. The ability to seamlessly share patient information is one of the long-term goals of the effort to digitize health care.
The analysis covered approximately 63 percent of all acute-care general hospitals in the U.S. Researchers did not include data on federal hospitals, which would have boosted figures somewhat–the Veterans Health Administration hospitals all use comprehensive electronic records. The findings follow a similar report released by the same group in 2008, which found that only 17 percent of doctors use such systems, and only 4 percent use the fullest versions.
Hospital administrators identified cost as the major barrier to adoption–these systems can cost a hospital anywhere from $2 million to hundreds of millions of dollars. The stimulus plan attempts to overcome this barrier by allocating $17 billion in incentives to physicians and hospitals. Beginning in 2011, hospitals can earn a one-time payment of $2 million for implementing EHRs, as well as extra Medicare funds. Physicians will be eligible to collect as much as $44,000 over five years in the form of extra Medicare payments.
Researchers say the second major hurdle is interoperability. Many hospitals have implemented individual systems–in radiology departments, for example–that don’t work with other systems. “Those pieces become difficult to overcome,” said Blumenthal. “That’s one of the reasons hospitals have been slow [to adopt electronic records].”
The stimulus legislation also attempts to deal with this issue. One of Blumenthal’s duties as the national coordinator will be to convene a committee on health information standards, though he declined to specify details at the press conference. “There are many ways to do that technically, but I’m not prepared to specify a particular approach at this point,” he said.