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Health Aff (Millwood). 2015 Dec;34(12):2174-80. doi: 10.1377/hlthaff.2015.0992. Epub 2015 Nov 11.

Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist.

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Julia Adler-Milstein ( is an assistant professor in the School of Information and in the Department of Health Management and Policy, School of Public Health, University of Michigan, in Ann Arbor.
Catherine M. DesRoches is a senior fellow at Mathematica Policy Research in Cambridge, Massachusetts.
Peter Kralovec is executive director at the Health Forum, in Chicago, Illinois.
Gregory Foster is a senior data analyst at the Health Research and Educational Trust, in Chicago, Illinois.
Chantal Worzala is a director for policy at the American Hospital Association in Washington, D.C.
Dustin Charles is a public health analyst at the Office of Planning, Evaluation, and Analysis, Office of the National Coordinator for Health Information Technology (ONC), in Washington, D.C.
Talisha Searcy is the director of research and evaluation at the Office of Planning, Evaluation, and Analysis, ONC.
Ashish K. Jha is a professor of health policy and management at the Harvard T.H. Chan School of Public Health, in Cambridge, Massachusetts.


Achieving nationwide adoption of electronic health records (EHRs) remains an important policy priority. While EHR adoption has increased steadily since 2010, it is unclear how providers that have not yet adopted will fare now that federal incentives have converted to penalties. We used 2008-14 national data, which includes the most recently available, to examine hospital EHR trends. We found large gains in adoption, with 75 percent of US hospitals now having adopted at least a basic EHR system--up from 59 percent in 2013. However, small and rural hospitals continue to lag behind. Among hospitals without a basic EHR system, the function most often not yet adopted (in 61 percent of hospitals) was physician notes. We also saw large increases in the ability to meet core stage 2 meaningful-use criteria (40.5 percent of hospitals, up from 5.8 percent in 2013); much of this progress resulted from increased ability to meet criteria related to exchange of health information with patients and with other physicians during care transitions. Finally, hospitals most often reported up-front and ongoing costs, physician cooperation, and complexity of meeting meaningful-use criteria as challenges. Our findings suggest that 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.


Hospitals; Information Technology

[Indexed for MEDLINE]

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