Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York 14215-3021, USA.
J Rural Health. 2012 Jan;28(1):16-27. doi: 10.1111/j.1748-0361.2011.00370.x. Epub 2011 Mar 18.
Health information technology (HIT) is a national policy priority. Knowledge about the special needs, if any, of rural health care providers should be taken into account as policy is put into action. Little is known, however, about rural-urban differences in HIT adoption at the national level.
To conduct the first national assessment of HIT in rural primary care offices, with particular attention to electronic medical record (EMR) adoption, range of capabilities in use, and plans for adoption.
A national mail survey of 5,200 primary care offices, stratified by rurality using Rural-Urban Commuting Area categories, was conducted in 2007-2008. Regression analyses were used to assess the relationship between office characteristics and EMR adoption, capabilities used, and future adoption plans.
A commercial EMR system was present in 31% of offices, with no significant differences by rurality. Of offices with EMRs, 12% reported using a full range of EMR capabilities, with 51% using a basic range and 37% using less than the basic range. Large Rural (adjusted OR = 3.71, P= .022) and Small Rural (aOR = 3.75, P= .049) offices were more likely than Urban offices to use a broader range of EMR capabilities. Among offices without EMRs, those in Isolated areas were less likely to have more immediate plans to adopt (aOR = 0.19, P= .02).
HIT adoption and use in rural primary care offices does not appear to be lower than in urban offices. The situation, however, is dynamic and warrants further monitoring.
健康信息技术（HIT）是国家政策重点。在实施政策时，应该考虑农村医疗服务提供者的特殊需求，如果有的话。然而，在国家一级，关于农村和城市地区 HIT 采用的差异，人们知之甚少。
对农村初级保健办公室的 HIT 进行首次全国评估，特别关注电子病历（EMR）的采用、使用的功能范围以及采用计划。
2007-2008 年，对 5200 个初级保健办公室进行了全国性的邮件调查，根据农村-城市通勤区类别进行分层，以评估办公室特征与 EMR 采用、使用的功能以及未来采用计划之间的关系。
31%的办公室配备了商业 EMR 系统，农村地区之间没有显著差异。在使用 EMR 的办公室中，有 12%报告使用了全面的 EMR 功能，51%使用了基本功能，37%使用了基本功能以下的功能。大型农村（调整后的 OR = 3.71，P=.022）和小型农村（aOR = 3.75，P=.049）办公室比城市办公室更有可能使用更广泛的 EMR 功能。在没有 EMR 的办公室中，孤立地区的办公室不太可能立即有更多的采用计划（aOR = 0.19，P=.02）。
农村初级保健办公室的 HIT 采用和使用似乎并不低于城市办公室。然而，情况是动态的，需要进一步监测。
