World Innovation Summit for Health, Qatar Foundation, Doha, Qatar.
Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas.
J Rural Health. 2017 Jun;33(3):275-283. doi: 10.1111/jrh.12193. Epub 2016 Jul 18.
To examine the difference between rural and urban hospitals as to their overall level of readiness for stage 2 meaningful use of electronic health records (EHRs) and to identify other key factors that affect their readiness for stage 2 meaningful use.
A conceptual framework based on the theory of organizational readiness for change was used in a cross-sectional multivariate analysis using 2,083 samples drawn from the HIMSS Analytics survey conducted with US hospitals in 2013.
Rural hospitals were less likely to be ready for stage 2 meaningful use compared to urban hospitals in the United States (OR = 0.49) in our final model. Hospitals' past experience with an information exchange initiative, staff size in the information system department, and the Chief Information Officer (CIO)'s responsibility for health information management were identified as the most critical organizational contextual factors that were associated with hospitals' readiness for stage 2. Rural hospitals lag behind urban hospitals in EHR adoption, which will hinder the interoperability of EHRs among providers across the nation. The identification of critical factors that relate to the adoption of EHR systems provides insights into possible organizational change efforts that can help hospitals to succeed in attaining meaningful use requirements.
Rural hospitals have increasingly limited resources, which have resulted in a struggle for these facilities to attain meaningful use. Given increasing closures among rural hospitals, it is all the more important that EHR development focus on advancing rural hospital quality of care and linkages with patients and other organizations supporting the care of their patients.
考察农村和城市医院在电子健康记录（EHR）第二阶段有意义使用方面的整体准备情况，并确定影响其第二阶段有意义使用准备情况的其他关键因素。
使用基于组织变革准备理论的概念框架，对 2013 年 HIMSS Analytics 在美国医院进行的调查中抽取的 2083 个样本进行横截面多变量分析。
与美国城市医院相比，农村医院在第二阶段有意义使用方面的准备程度较低（OR=0.49）。医院在信息交换计划方面的过往经验、信息系统部门的员工规模以及首席信息官（CIO）负责健康信息管理，这三个因素被确定为与医院第二阶段准备情况最相关的组织背景关键因素。农村医院在电子病历的采用方面落后于城市医院，这将阻碍全国范围内提供者之间电子病历的互操作性。确定与电子病历系统采用相关的关键因素为医院提供了一些见解，这些见解可能有助于组织变革努力，帮助医院成功实现有意义的使用要求。
农村医院的资源越来越有限，这导致这些医疗机构难以实现有意义的使用。鉴于农村医院的关闭越来越多，电子病历的发展更应该注重提高农村医院的护理质量，并与患者和其他支持患者护理的组织建立联系。
