Cited by 1,473Electronic Health Records SystemsMedical Coding and Health InformationNursing Diagnosis and Documentation

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Use of Electronic Health Records in U.S. Hospitals

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Jha, Ashish K., DesRoches, Catherine M., Campbell, Eric G., Donelan, Karen, Rao, Sowmya R., Ferris, Timothy G., Shields, Alexandra, Rosenbaum, Sara, Blumenthal, David·2009·New England Journal of Medicine

DOI 10.1056/nejmsa0900592

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Abstract

BACKGROUND: Despite a consensus that the use of health information technology should lead to more efficient, safer, and higher-quality care, there are no reliable estimates of the prevalence of adoption of electronic health records in U.S. hospitals. METHODS: We surveyed all acute care hospitals that are members of the American Hospital Association for the presence of specific electronic-record functionalities. Using a definition of electronic health records based on expert consensus, we determined the proportion of hospitals that had such systems in their clinical areas. We also examined the relationship of adoption of electronic health records to specific hospital characteristics and factors that were reported to be barriers to or facilitators of adoption. RESULTS: On the basis of responses from 63.1% of hospitals surveyed, only 1.5% of U.S. hospitals have a comprehensive electronic-records system (i.e., present in all clinical units), and an additional 7.6% have a basic system (i.e., present in at least one clinical unit). Computerized provider-order entry for medications has been implemented in only 17% of hospitals. Larger hospitals, those located in urban areas, and teaching hospitals were more likely to have electronic-records systems. Respondents cited capital requirements and high maintenance costs as the primary barriers to implementation, although hospitals with electronic-records systems were less likely to cite these barriers than hospitals without such systems. CONCLUSIONS: The very low levels of adoption of electronic health records in U.S. hospitals suggest that policymakers face substantial obstacles to the achievement of health care performance goals that depend on health information technology. A policy strategy focused on financial support, interoperability, and training of technical support staff may be necessary to spur adoption of electronic-records systems in U.S. hospitals.

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Authors: Jha, A. K., DesRoches, C. M., Campbell, E. G., Donelan, K., Rao, S. R., Ferris, T. G., Shields, A., Rosenbaum, S., & Blumenthal, D.
Affiliations: Brigham and Women's Hospital (US)
Massachusetts General Hospital (US)
George Washington University (US)
ORCID: Jha, Ashish K.
DesRoches, Catherine M.
Campbell, Eric G.
Donelan, Karen
Rao, Sowmya R.
Shields, Alexandra
Rosenbaum, Sara
Blumenthal, David
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 2009-04-16
Volume: 360
Issue: 16
Pages: 1628-1638
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejmsa0900592
OpenAlex: W2157814042
Cited by: 1,473
References: 20
Citations by year: 2026: 35 · 2025: 45 · 2024: 45 · 2023: 81 · 2022: 40 · 2021: 42 · 2020: 55 · 2019: 71 · 2018: 68 · 2017: 53 · 2016: 62 · 2015: 95 · 2014: 138 · 2013: 134 · 2012: 153
FWCI: 358.97
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Health and Human Services
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Health Sciences › Nursing › Research and Theory › Nursing Diagnosis and Documentation
Keywords: electronic health records, health information technology adoption, hospitals, computerized physician order entry, barriers to adoption, hospital characteristics, teaching hospitals, health policy, interoperability
MeSH terms: Diffusion of Innovation, Hospital Administration, Hospital Bed Capacity, Ownership, United States, Logistic Models, Medical Records Systems, Computerized, Health Care Surveys

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