Office of the National Coordinator, US Department of Health and Human Services, Washington, DC 20201, USA.
Am J Manag Care. 2010 Dec;16(12 Suppl HIT):e293-301.
To develop measures of the use of electronic health records (EHRs) that accurately reflect the full continuum of hospital adoption and progress toward meaningful use and to understand the intercorrelations and patterns associated with hospital adoption of specific EHR functions.
This study analyzed the 2009 American Hospital Association (AHA) information technology (IT) supplement survey. The main section of this survey assessed the adoption and use of 24 EHR functionalities in the following major categories: electronic clinical documentation, results viewing, computerized provider order entry, and clinical decision support.
This study relied on descriptive statistical methods and a principal component factor analysis.
We found that 11.4% of hospitals met all and 48.3% met half or more of the core criteria that are included in both the AHA IT survey and the final "meaningful-use" rule. The results from our factor analysis imply that hospitals adopt groups of similar EHR functions, but choices to adopt across major categories are relatively independent.
Many hospitals have adopted multiple features of EHRs and tend to use a staged adoption strategy based on logical groupings of functions. These results indicate to policymakers that there is no single path toward adoption of advanced EHR systems.
开发能准确反映医院采用电子病历（EHR）的全连续体，以及朝着有意义的使用方向取得进展的措施，并了解与医院采用特定 EHR 功能相关的相互关联和模式。
本研究分析了 2009 年美国医院协会（AHA）信息技术（IT）补充调查。该调查的主要部分评估了以下主要类别的 24 种 EHR 功能的采用和使用情况：电子临床文档、结果查看、计算机化医嘱录入和临床决策支持。
本研究依赖于描述性统计方法和主成分因子分析。
我们发现，11.4%的医院满足了 AHA IT 调查和最终“有意义使用”规则中包含的所有核心标准，48.3%的医院满足了一半或更多核心标准。我们的因子分析结果表明，医院采用了类似的 EHR 功能组，但在主要类别之间的采用选择是相对独立的。
许多医院已经采用了 EHR 的多种功能，并且倾向于根据功能的逻辑分组采用分阶段的采用策略。这些结果向政策制定者表明，采用先进的 EHR 系统没有单一的途径。
