Electronic records lag at hospitals U.S. doesn’t pay for tech upgrades
By Lisa Rapaport (Reuters Health) - Psychiatric, long-term care and rehabilitation hospitals that don’t qualify for U.S. subsidies to adopt electronic medical records aren’t upgrading to this technology as quickly as hospitals that receive cash incentives, a recent study suggests. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 set aside incentive payments through the government health programs Medicare and Medicaid for eligible hospitals and providers that adopted electronic health records (EHRs). Four years later, roughly 59 percent of hospitals eligible for subsidies had adopted at least basic EHR systems, the study found. But among facilities ineligible for this financial help, only about 20 percent of rehabilitation hospitals and even fewer psychiatric or long-term care facilities had adopted EHRs by 2013. “In the U.S., healthcare is currently delivered in silos,” said lead study author Daniel Walker of The Ohio State University College of Medicine in Columbus. “As patients move across the healthcare system, their record does not move with them – leading to poor care coordination, cost escalation, and quality and safety issues,” Walker added by email. To assess EHR adoption rates based on whether hospitals qualified for incentive payments, Walker and colleagues analyzed survey data collected by the American Hospital Association from 2009 to 2013. They categorized hospitals as having at least a basic EHR if the system met a minimum threshold of capabilities and was deployed in at least one hospital unit. Then, the researchers also assessed something known as meaningful use, or whether the EHR systems actually made it possible for hospitals to save patient data and share it with other providers. By 2013, about 44 percent of hospitals eligible for subsidies met meaningful use criteria, up from less than 5 percent in 2009. Less than 15 percent of long-term care or rehabilitation hospitals and less than 10 percent of psychiatric hospitals met meaningful use criteria by 2013, however. One shortcoming of the study is that a high proportion of U.S. hospitals didn’t complete survey questions on technology, limiting the data on EHR adoption, the researchers note in Health Affairs. Even so, the findings suggest a need to improve record systems at many hospitals that may deal with chronically ill patients who are in particular need of better-coordinated care, noted Ann Kutney-Lee, a health policy researcher at the University of Pennsylvania School of Nursing in Philadelphia, by email. “Patients who are treated in long-term care, rehabilitation and psychiatric facilities without the benefit of ah EHR may be at risk of poorer coordination of services and potentially lower quality of care,” said Kutney-Lee, who wasn’t involved in the new study. Beyond care coordination, widespread adoption of EHRs would create a treasure trove of data researchers could mine to identify better ways to treat diseases, avoid mistakes or identify the most cost-effective treatments, said Dean Sittig, a health quality researcher at the University of Texas Health Science Center at Houston who also wasn’t involved in the study. “EHRs shine a bright light on the actions and activities of all involved in the healthcare delivery process,” Sittig added by email. “In addition, it would be much easier for families or patients within these facilities to understand what was, or was not, being done for their loved ones.” SOURCE: http://bit.ly/24q56a0 Health Affairs, March 2016.
