Pre-pandemic assessment: a decade of progress in electronic health record adoption among U.S. hospitals

John Xuefeng Jiang; Kangkang Qi; Ge Bai; Kevin Schulman

doi:10.1093/haschl/qxad056

Pre-pandemic assessment: a decade of progress in electronic health record adoption among U.S. hospitals

Health Aff Sch. 2023 Oct 21;1(5):qxad056. doi: 10.1093/haschl/qxad056. eCollection 2023 Nov.

Authors

John Xuefeng Jiang¹, Kangkang Qi², Ge Bai^{3

4}, Kevin Schulman^{5

6}

Affiliations

¹ Eli Broad College of Business, Michigan State University, East Lansing, MI 48824, United States.
² Harbert College of Business, Auburn University,Auburn, AL 36949,United States.
³ Johns Hopkins Carey Business School, Baltimore, MD 21202, United States.
⁴ Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
⁵ Clinical Excellence Research Center, Stanford University School of Medicine, Palo Alto, CA 94304, United States.
⁶ Stanford Graduate School of Business, Stanford, CA 94305, United States.

Abstract

As the COVID-19 pandemic loomed, the adoption of electronic health records (EHRs) in US hospitals became a pivotal concern. This study provides a pre-pandemic assessment, highlighting a decade of progress in EHR adoption from 2009 to 2019, with the last available survey conducted from January to June of 2020. It delves into the current EHR adoption rates, variations across different hospital categories, the influence of major vendors, and the challenges in implementing these systems. The study found that basic EHR adoption surged from 6.6% to 81.2%, while comprehensive systems increased from 3.6% to 63.2%. Despite this growth, the findings point to enduring disparities among hospitals, a concentrated market share by 6 vendors (90%), and significant concerns regarding maintenance costs. These insights provide an invaluable snapshot of the state of EHR adoption at the brink of the pandemic, serving as a benchmark to assess hospitals' readiness to utilize digital infrastructure in health care. The conclusions underscore the necessity for strategic policy interventions to encourage a competitive landscape and guarantee equitable access, ultimately strengthening the health care system's responsiveness to global health crises such as COVID-19.

Keywords: EHR; EHR vendors; pandemic; telemedicine.