A report sponsored by the Robert Wood Johnson foundation and prepared by Mathematica and the Harvard School of Public Health examines the current state of use of information technology in the United States and compares it to other countries. (RWJ Report) The report draws largely on surveys funded by the HHS office for health information technology. According to the authors, in 2012 about 40% of physicians had adopted a basic EHR, with primary care physicians more likely to be using one than specialists, physicians in larger practices more likely than those in smaller ones and rural doctors more likely than those in urban areas. Most of the physicians with an EHR were using it in a manner consistent with most of the meaningful use requirements. Doctors did, however, note significant problems in the use of the systems. Hospitals had a lower rate of basic EHR use, at only about 44%. Larger and urban hospitals were more likely users. So overall provider use is increasing, but still not high, and there are problems implementing and using EHRs. In regard to health information exchange, which is a critical capability for true meaningful use of electronic records to coordinate and facilitate better care, although significant federal funding has been made available, most exchange efforts are behind schedule and running into problems. Private efforts are doing better but don’t typically allow for true open-ended information sharing. One key issue is finding a funding mechanism that will sustain the HIEs. Some areas like drug prescribing and lab test result sharing are doing fine, probably because they are run by private entities which have provided stable funding. Finally, as might be expected, use in the United States of both EHRs and information sharing networks lags most other developed countries.
