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December, 2014


Where Are We on the Diffusion Curve? Trends and Drivers of Primary Care Physicians’ Use of Health Information Technology

Audet A-MJ et al, Health Serv Res, 49(1 Pt2)

To describe trends in primary care physicians’ use of health information technology (HIT) between 2009 and 2012, examine practice characteristics associated with greater HIT capacity in 2012, and explore factors such as delivery system and payment reforms that may affect adoption and functionality.

We used data from the 2012 and 2009 Commonwealth Fund International Health Policy Surveys of Primary Care Physicians. The data were collected in both years by postal mail between March and July among a nationally representative sample of primary care physicians in the United States.
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Published: February 2014 |
Keyword(s): Adoption, Electronic Health Records, United States

Adoption Of Electronic Health Records Grows Rapidly, But Fewer Than Half Of US Hospitals Had At Least A Basic System In 2012

DesRoches CM et al, Health Affairs, 2013

The US health care system is in the midst of an enormous change in the way health care providers and hospitals document, monitor, and share information about health and care delivery. Part of this transition involves a wholesale, but currently uneven, shift from paper-based records to electronic health record (EHR) systems. We used the most recent longitudinal survey of US hospitals to track how they are adopting and using EHR systems. Only 44 percent of hospitals report having and using what we define as at least a basic EHR system. And although 42.2 percent meet all of the federal stage 1 “meaningful-use” criteria, only 5.1 percent could meet the broader set of stage 2 criteria.
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Published: 9 July 2013 |
Keyword(s): Adoption, Electronic Health Records, Hospitals, Information Technology, Meaningful Use, Paper Conversion

Iproving the electronic health record—are clinicians getting what they wished for?

Cimino JJ, JAMA, 309(10)

Pleas for improvement in patient health records date back to Florence Nightingale and have persisted well into the 21st century. Computer-based records, currently referred to as electronic health records (EHRs), have been proposed as a means for improving availability, legibility, and completeness of patient information.
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Published: 13 March 2013 |
Keyword(s): Adoption, Electronic Health Records, Physicians

The Rise of Electronic Health Record Adoption Among Family Physicians

Xierali IM et al, The Annals of Family Medicine, 11(1)

Realizing the benefits of adopting electronic health records (EHRs) in large measure depends heavily on clinicians and providers’ uptake and meaningful use of the technology. This study examines EHR adoption among family physicians using 2 different data sources, compares family physicians with other office-based medical specialists, assesses variation in EHR adoption among family physicians across states, and shows the possibility for data sharing among various medical boards and federal agencies in monitoring and guiding EHR adoption.
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Published: 2 January 2013 |
Keyword(s): Adoption, Electronic Health Records, General practitioners, Primary Care, United States

Small Physician Practices In New York Needed Sustained Help To Realize Gains In Quality From Use Of Electronic Health Records

Ryan AM et al, Health Affairs, 32(1)

The 2009 American Recovery and Reinvestment Act spurred adoption of electronic health records (EHRs) in the United States, through such measures as financial incentives to providers through Medicare and Medicaid and regional extension centers, which provide ongoing technical assistance to practices. Yet the relationship between EHR adoption and quality of care remains poorly understood. We evaluated the early effects on quality of the Primary Care Information Project, which provides subsidized EHRs and technical assistance to primary care practices in underserved neighborhoods in New York City, using the regional extension center model.
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Published: 1 January 2013 |
Keyword(s): Adoption, Electronic Health Records, Information Technology, Primary Care, Quality, United States

Separate may not be equal: A preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers

Kozubal DE et al, International Journal of Medical Informatics, 2012

Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR.

Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether their psychiatric records were stored electronically and accessible to non-psychiatric physicians. Electronic hospital records and accessibility statuses were correlated with patient care outcomes obtained from the University Health System Consortium Clinical Database available for 13 of the 18 top US hospitals.
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Published: 20 December 2012 |
Keyword(s): Accesibility, Adoption, e-Health, Electronic Health Records, Electronic Medical Records, Psychiatry, United States

Adoption of and experience with e-prescribing by primary care physicians

Jariwala KS et al, Research in Social and Administrative Pharmacy, 2012

The impetus of electronic prescribing (e-prescribing) is the reduction of preventable medication errors by generating a legible prescription checked via e-prescribing software for drug-drug and other interactions. Although the adoption of e-prescribing among physicians is growing, the Institute of Medicine’s recommendations that all prescriptions be routed electronically by 2010 certainly has not been met.
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Published: 12 June 2012 |
Keyword(s): Adoption, Electronic Prescribing, Primary Care, United States

Adoption of Information Technology in Primary Care Physician Offices in Alberta and Denmark, Part 2: A Novel Comparison Methodology

Protti D et al, ElectronicHealthcare, 8(1)

This article follows on from part 1 on the history of medical computing in Alberta and Denmark (Protti et al. 2007). It provides background to the driving forces for automation in primary care physician offices in Denmark and Alberta. It also summarizes the functionality of electronic medical records (EMRs) in both jurisdictions and compares the status of primary care physician office computing in Alberta to that of Denmark.
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Published: 15 May 2007 |
Keyword(s): Adoption, Canada, Denmark, Electronic Health Records, Health Information Technology, Physicians, Primary Health Care

Electronic health record adoption and health information exchange among hospitals in New York State

Abramson EL et al, Journal of evaluation in clinical practice, 2011

Rationale, aims and objectives 
Unprecedented national and state initiatives are underway to promote adoption and meaningful use of electronic health records (EHRs) with health information exchange (HIE). New York State leads the nation in state initiatives and is conducting ongoing surveillance of its investments. Lessons learned from studying states like New York can inform federal policies and will be essential to evaluate the effectiveness of these initiatives. We undertook this first in a series of planned surveys to assess EHR adoption and HIE activities by New York State hospitals.
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Published: 13 September 2011 |
Keyword(s): Adoption, Electronic Health Records, Health Information Exchange, Hospitals, United States

Small, Nonteaching, And Rural Hospitals Continue To Be Slow In Adopting Electronic Health Record Systems

DesRoches CM et al, Health Affairs, 2012

To achieve the goal of comprehensive health information record keeping and exchange among providers and patients, hospitals must have functioning electronic health record systems that contain patient demographics, care histories, lab results, and more. Using national survey data on US hospitals from 2011, the year federal incentives for the meaningful use of electronic health records began, we found that the share of hospitals with any electronic health record system increased from 15.1 percent in 2010 to 26.6 percent in 2011, and the share with a comprehensive system rose from 3.6 percent to 8.7 percent. The proportion able to meet our proxy criteria for meaningful use also rose; in 2011, 18.4 percent of hospitals had these functions in place in at least one unit and 11.2 percent had them across all clinical units.
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Published: 24 April 2012 |
Keyword(s): Adoption, Electronic Health Records, Hospitals, Information Technology, United States

Physicians In Nonprimary Care And Small Practices And Those Age 55 And Older Lag In Adopting Electronic Health Record Systems

Decker SL et al, Health Affairs, 2012

By 2011 more than half of all office-based physicians were using electronic health record systems, but only about one-third of those physicians had systems with basic features such as the abilities to record information on patient demographics, view laboratory and imaging results, maintain problem lists, compile clinical notes, or manage computerized prescription ordering. Basic features are considered important to realize the potential of these systems to improve health care.
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Published: 24 April 2012 |
Keyword(s): Adoption, Electronic Health Records, Information Technology, Physicians, United States

The LITIS conceptual framework: measuring eHealth readiness and adoption dynamics across the Healthcare Organizations

Tamburis O. Health and Technology, 2012

The Italian Federation of Healthcare Trusts and Municipalities promoted a national initiative, named LITIS, on the levels of technological innovation in healthcare, to assist its members in the governance of the eHealth phenomenon. The result is a toolkit (i) to compare the policies among HealthCare Organizations (HCOs) within a jurisdiction; (ii) to help negotiate and monitor the balanced evolution of eHealth solutions within and across the HCOs, and (iii) to facilitate the collaboration among HCOs to face common topics. The primary achievement is a Conceptual Framework, spanning over the complete spectrum of the support to care and administrative processes, assuming two perspectives: the Functions F (services for citizens, social/healthcare professionals, managers, administrative staff) and the Enabling Components C (prerequisites to deploy the Functions and handle the change).
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Published: 13 April 2012 |
Keyword(s): Adoption, e-Health, Electronic Health Records, Innovation, Italy

Hospitals ineligible for federal meaningful-use incentives have dismally low rates of adoption of electronic health records

Wolf L et al, Health Affairs, 31(3)

The US government has dedicated substantial resources to help certain providers, such as short-term acute care hospitals and physicians, adopt and meaningfully use electronic health record (EHR) systems. We used national data to determine adoption rates of EHR systems among all types of inpatient providers that were ineligible for these same federal meaningful-use incentives: long-term acute care hospitals, rehabilitation hospitals, and psychiatric hospitals. Adoption rates for these institutions were dismally low: less than half of the rate among short-term acute care hospitals.
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Published: March 2012 |
Keyword(s): Adoption, Electronic Health Records, Hospitals, Incentives, Meaningful Use, United States

Matrix Analysis of the Digital Divide in eHealth Services Using Awareness, Want, and Adoption Gap

Liang T-H. J Med Internet Res, 14(1)

The digital divide usually refers to access or usage, but some studies have identified two other divides: awareness and demand (want). Given that the hierarchical stages of the innovation adoption process of a customer are interrelated, it is necessary and meaningful to analyze the digital divide in eHealth services through three main stages, namely, awareness, want, and adoption.
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Published: 13 February 2012 |
Keyword(s): Adoption, Awareness, Behavior, Digital Divide, e-Health, Taiwan

Translating standards into practice: Experience and lessons learned at the Department of Veterans Affairs

Bouhaddou O et al, Journal of Biomedical Informatics, 2012

The increased need for interoperable electronic health records in health care organizations underscores the importance of standards. The US Department of Veterans Affairs (VA) has a long history of developing and adopting various types of health care data standards. The authors present in detail their experience in this domain. A formal organization within VA is responsible for helping to develop and implement standards. This group has produced a Standards Life Cycle (SLC) process endorsed by VA key business and information technology (IT) stakeholders. It coordinates the identification, description, and implementation of standards aligned with VA business requirements.
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Published: 20 January 2012 |
Keyword(s): Adoption, Electronic Health Records, Implementation, Interoperability, Standards, United States, Veterans Affairs

Adoption and Meaningful Use of Computerized Physician Order Entry With an Integrated Clinical Decision Support System for Radiology: Ten-Year Analysis in an Urban Teaching Hospital

Ip IK et al, Journal of the American College of Radiology, 9(2)

The aim of this study was to assess whether an integrated imaging computerized physician order entry (CPOE) system with embedded decision support for imaging can be accepted clinically.
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Published: February 2012 |
Keyword(s): Adoption, Clinical decision support systems, CPOE, Imaging, Meaningful Use, Radiology, United States

White Paper on e-Health Adoption

Newsham D et al, ElectronicHealthcare, 10(3)

Significant progress is being made in the clinical adoption of electronic records in hospitals, regions, clinics, communities and jurisdictions across Canada. The goal of such adoption is to enable continuing improvements in patient care quality, safety and effectiveness at a time when the healthcare system faces increasing performance, capacity and sustainability pressures. We know that transformative changes involving the implementation of new information systems and technologies do not occur overnight – adoption is a journey and the realization of the full benefits of our investments will require sustained effort, innovation and continuous learning for health informatics professionals along with our clinical colleagues.
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Published: 15 January 2012 |
Keyword(s): Adoption, Canada, Electronic Health Records, Hospitals

Enabling international adoption of LOINC through translation

Vreeman DJ et al, Journal of Biomedical Informatics, 2012

Interoperable health information exchange depends on adoption of terminology standards, but international use of such standards can be challenging because of language differences between local concept names and the standard terminology. To address this important barrier, we describe the evolution of an efficient process for constructing translations of LOINC terms names, the foreign language functions in RELMA, and the current state of translations in LOINC. We also present the development of the Italian translation to illustrate how translation is enabling adoption in international contexts. We built a tool that finds the unique list of LOINC Parts that make up a given set of LOINC terms.
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Published: 21 February 2012 |
Keyword(s): Adoption, Electronic Health Records, LOINC, Standards, Terminology, Translating

The Effect of Hospital Electronic Health Record Adoption on Nurse-Assessed Quality of Care and Patient Safety

Kutney-Lee A, Kelly D. The Journal of Nursing Administration, 41(11)

The aim of this study was to examine the effect of having a basic electronic health record (EHR) on nurse-assessed quality of care, including patient safety. Few large-scale studies have examined how adoption of EHRs may be associated with quality of care. A cross-sectional, secondary analysis of nurse and hospital survey data was conducted. The final sample included 16,352 nurses working in 316 hospitals in 4 states.
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Published: November 2011 |
Keyword(s): Adoption, Electronic Health Records, Hospitals, Nurses, Patient Safety, Quality of Health Care, United States

Adoption of telemedicine: from pilot stage to routine delivery

Zanaboni P, Wootton R. BMC Medical Informatics and Decision Making, 12

Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery.
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Published: 4 January 2012 |
Keyword(s): Adoption, Telemedicine, Teleradiology

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