Will slow adoption of health IT hinder health reform?

Much of the hoped-for health care advances targeted by health reform efforts rely, at least in part, on a robust electronic medical record (EMR) system. Efforts ranging from improving chronic disease maintenance, reducing prescription drug errors, to the ever-ambiguous goal of "reducing waste and increasing efficiency" are looking to the enhanced communication potential presented by EMR. So how are hospital efforts at EMR integration doing at this early stage in the health reform marathon? That's the question that Harvard School of Public Health researchers set out to answer with a paper in the current issue of Health Affairs.

So how's progress? In a word: slow. The Harvard group used a robust data set collected, managed, and sold by the American Hospital Association that reports on the presence or absence of 32 clinical functions in the EMR systems of just over 3,000 hospitals in the US. The data shows that hospitals adopted basic or comprehensive EMR systems at a rate of 8.7% in 2008 and 11.9% in 2009. Though this indicates a possible accelerating trend that could be good news for health reform efforts, only 2% of hospitals currently meet the federal government's "meaningful use" standard. The meaningful use standards cover a dozen or so basic functions, such as electronic prescribing, and must be met by 2012 if hospitals want to access additional funding through Medicare and Medicaid. As one might expect, rural and smaller community hospitals were the farthest behind. Unfortunately, they may be the ones whose patients could benefit the most from many health reform efforts depending on electronic information systems.

The good news? Health IT as a business and innovation sector is wide open for healthy solutions. And the government has sweetened the deal with the meaningful use incentives. This means hospitals may be able to offset some of their development costs when their IT efforts reach those federal standards.

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