Study: Few hospitals have EHRs in all clinical units

Larger, urban and teaching hospitals were more likely than other hospitals to have EHR systems. Don May, AHA vice president for policy, said the survey “validates what our members have been telling us. More and more hospitals are moving towards IT adoption, but are doing so in incremental steps.”


According to a survey published online today by the New England Journal of Medicine, 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), and up to 10.9% of hospitals have more basic EHR systems in at least one clinical unit, according to the survey of nearly 3,000 hospitals, conducted from March to September 2008.


Many more hospitals have or are implementing key EHR functions in one or more units, such as electronic laboratory and radiologic reports and computerized provider-order entry for medications or laboratory tests. 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. Respondents cited capital requirements and high maintenance costs as the primary barriers to EHR adoption.


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.The survey by researchers at the Harvard School of Public Health, Massachusetts General Hospital, Brigham and Women’s Hospital, VA Boston Healthcare System and George Washington University was included as a supplement to the AHA Annual Survey.


(SOURCES: National Quality Forum,, accessed March 26, 2009)