Trending in the right direction: critical access hospitals increased adoption of advanced electronic health record functions from 2018 to 2023.

IF 4.7 2区 医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS Journal of the American Medical Informatics Association Pub Date : 2024-11-06 DOI:10.1093/jamia/ocae267
Nate C Apathy, A Jay Holmgren, Paige Nong, Julia Adler-Milstein, Jordan Everson
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Abstract

Objectives: We analyzed trends in adoption of advanced patient engagement and clinical data analytics functionalities among critical access hospitals (CAHs) and non-CAHs to assess how historical gaps have changed.

Materials and methods: We used 2014, 2018, and 2023 data from the American Hospital Association Annual Survey IT Supplement to measure differences in adoption rates (ie, the "adoption gap") of patient engagement and clinical data analytics functionalities across CAHs and non-CAHs. We measured changes over time in CAH and non-CAH adoption of 6 "core" clinical data analytics functionalities, 5 "core" patient engagement functionalities, 5 new patient engagement functionalities, and 3 bulk data export use cases. We constructed 2 composite measures for core functionalities and analyzed adoption for other functionalities individually.

Results: Core functionality adoption increased from 21% of CAHs in 2014 to 56% in 2023 for clinical data analytics and 18% to 49% for patient engagement. The CAH adoption gap in both domains narrowed from 2018 to 2023 (both P < .01). More than 90% of all hospitals had adopted viewing and downloading electronic data and clinical notes by 2023. The largest CAH adoption gaps in 2023 were for Fast Healthcare Interoperability Resources (FHIR) bulk export use cases (eg, analytics and reporting: 63% of CAHs, 81% of non-CAHs, P < .001).

Discussion: Adoption of advanced electronic health record functionalities has increased for CAHs and non-CAHs, and some adoption gaps have been closed since 2018. However, CAHs may continue to struggle with clinical data analytics and FHIR-based functionalities.

Conclusion: Some crucial patient engagement functionalities have reached near-universal adoption; however, policymakers should consider programs to support CAHs in closing remaining adoption gaps.

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趋势方向正确:2018 年至 2023 年,关键通道医院增加了先进电子病历功能的采用。
目的:我们分析了重症监护医院(CAH)和非重症监护医院采用先进的患者参与和临床数据分析功能的趋势:我们分析了关键通道医院(CAH)和非CAH采用先进的患者参与和临床数据分析功能的趋势,以评估历史差距的变化情况:我们使用《美国医院协会年度调查 IT 补充报告》中的 2014 年、2018 年和 2023 年数据来衡量重症监护医院和非重症监护医院在患者参与和临床数据分析功能采用率方面的差异(即 "采用差距")。我们测量了 CAH 和非 CAH 对 6 个 "核心 "临床数据分析功能、5 个 "核心 "患者参与功能、5 个新的患者参与功能和 3 个批量数据导出用例的采用率随时间的变化情况。我们为核心功能构建了两个综合衡量标准,并对其他功能的采用情况进行了单独分析:采用核心功能的 CAH 在临床数据分析方面的比例从 2014 年的 21% 提高到 2023 年的 56%,在患者参与方面的比例从 18% 提高到 49%。从 2018 年到 2023 年,CAH 在这两个领域的采用率差距均有所缩小(均为 P 讨论):CAH 和非 CAH 对高级电子病历功能的采用率有所提高,自 2018 年以来,一些采用率差距已经缩小。然而,CAH 可能会继续在临床数据分析和基于 FHIR 的功能方面苦苦挣扎:一些重要的患者参与功能已接近普遍采用;然而,政策制定者应考虑制定计划,支持 CAH 缩小剩余的采用差距。
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来源期刊
Journal of the American Medical Informatics Association
Journal of the American Medical Informatics Association 医学-计算机:跨学科应用
CiteScore
14.50
自引率
7.80%
发文量
230
审稿时长
3-8 weeks
期刊介绍: JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
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Trending in the right direction: critical access hospitals increased adoption of advanced electronic health record functions from 2018 to 2023. Evaluating gradient-based explanation methods for neural network ECG analysis using heatmaps. The role of routine and structured social needs data collection in improving care in US hospitals. Correction to: Artificial intelligence for optimizing recruitment and retention in clinical trials: a scoping review. Is ChatGPT worthy enough for provisioning clinical decision support?
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