Jiang John Xuefeng, Ross Joseph S, Bai Ge
Accounting & Information Systems, Eli Broad College of Business, Michigan State University, East Lansing, USA.
Yale School of Medicine, Yale University, New Haven, USA.
J Gen Intern Med. 2024 Oct;39(13):2438-2445. doi: 10.1007/s11606-024-08853-0. Epub 2024 Jul 10.
Telemedicine has emerged as a vital healthcare delivery model, especially pronounced during the COVID-19 pandemic. Our study uniquely focuses on an institutional lens, examining US hospitals to offer targeted policy implications.
To investigate the trend in telemedicine adoption across US hospitals from 2017 to 2022 and analyze the institutional challenges they encounter, particularly in the realm of electronic health information exchange.
Cross-sectional study leveraging data from the American Hospital Association's (AHA) annual surveys for the years 2017 to 2021 and the 2022 AHA IT Supplement Survey.
The study includes a national sample of US hospitals, covering a diverse range of hospital types including large, nonprofit, teaching, and system-affiliated institutions.
US hospitals form the study's participants, with a substantial response rate to the surveys.
Key metrics include the number of telemedicine patient encounters, percentage of hospitals offering telemedicine services, and institutional challenges to electronic health information exchange.
Telemedicine encounters saw a 75% increase, growing from approximately 111.4 million in 2020 to nearly 194.4 million in 2021. The percentage of hospitals offering at least one form of telemedicine service went from 46% in 2017 to 72% in 2021. Larger, nonprofit, and teaching hospitals were more prone to telehealth adoption, without notable urban-rural disparities. While over 90% of hospitals allow patients to view and download medical records, only 41% permit online data submission. Importantly, 25% of hospitals identified Certified Health IT Developers such as EHR vendor as frequent culprits in information blocking, with cost being the primary obstacle.
The findings underscore the rapid yet uneven adoption of telemedicine services in U.S. hospitals. The results point to the need for comprehensive policy interventions to address the challenges identified and realize telemedicine's full potential in healthcare delivery and resilience.
远程医疗已成为一种至关重要的医疗服务提供模式，在新冠疫情期间尤为显著。我们的研究独特地聚焦于机构层面，通过对美国医院的考察来提供有针对性的政策建议。
调查2017年至2022年美国医院采用远程医疗的趋势，并分析它们所面临的机构性挑战，尤其是在电子健康信息交换领域。
横断面研究，利用美国医院协会（AHA）2017年至2021年年度调查以及2022年AHA信息技术补充调查的数据。
该研究包括美国医院的全国性样本，涵盖各种类型的医院，包括大型、非营利性、教学型和系统附属机构。
美国医院是该研究的参与者，对调查的回应率较高。
关键指标包括远程医疗患者就诊次数、提供远程医疗服务的医院百分比以及电子健康信息交换的机构性挑战。
远程医疗就诊次数增加了75%，从2020年的约1.114亿次增长到2021年的近1.944亿次。提供至少一种远程医疗服务形式的医院百分比从2017年的46%升至2021年的72%。大型、非营利性和教学型医院更倾向于采用远程医疗，城乡之间没有明显差异。虽然超过90%的医院允许患者查看和下载病历，但只有41%允许在线提交数据。重要的是，25%的医院认为电子健康记录供应商等认证的健康信息技术开发商是信息阻塞的常见罪魁祸首，成本是主要障碍。
研究结果强调了美国医院对远程医疗服务的快速但不均衡的采用。结果表明需要采取全面的政策干预措施来应对所发现的挑战，并在医疗服务提供和恢复力方面实现远程医疗的全部潜力。
