EHR Implementation: Facing the Digital Divide

In our digitally-dominated world, why is it that nearly 20% of America’s health systems still do not use electronic health records? EHRs provide a simple, easy way to communicate and transfer patient health information in the digital world. Medical professionals can keep up with changing patient information in one central location, and grant record access to anyone necessary. This eliminates the risk of losing important paper files. Although the technology is readily available and extremely beneficial to any medical system, the implementation of EHRs has been a slow process.

“Electronic health records have the potential to help reduce medical errors, lower costs and empower patients. However, without the widespread adoption of electronic health records by small and medium physician practices … and the requirements for achieving the interconnectivity necessary to allow for the effective exchange of health related information, the benefits of information technology cannot be fully realized.”
~ Carol Diamond, MD
Managing Director at the Markle Foundation and Chair of Connecting for Health

As seen in the recent case of Huston’s Hurricane Harvey, EHR systems can save lives. Many patients were evacuated to other southern Texas hospitals due to severe flood danger, leaving behind their usual doctor’s office. Thanks to electronic health records, all doctors could access critical patient information via internet for those evacuated patients. Without the use of this technology, paper patient records could have been destroyed in the hurricane damage, like in Hurricane Katrina of 2005.

Although the systems and software for electronic record keeping are widely available, cost barriers continue to inhibit the implementation process.

According to a recent study published in the Journal of the American Medical Informatics Association detailing the latest statistics on hospital EHR implementation, about 81% have adopted a basic EHR system. Although this is a substantial number, it is only 5% higher than the implementation rate of 2014. Also, only 38% of hospitals have employed at least eight of ten data performance measurement functions and 42% have adopted eight patient engagement capabilities.

The study also found implementation problems appear greatest in rural safety-net hospitals that struggle to fund modern technology. The HITECH Act of 2009 provided billions in funding to ease hospital EHR adoption, but it soon became obvious that additional incentives would be necessary to further increase implementation in critical access hospitals.

In 2015, the Center for Medicare and Medicaid Services implemented the Medicare Access and CHIP Reauthorization Act (MACRA), which includes the Merit-based Incentive Payment System (MIPS). Under MIPS, a health system has all of 2017 to implement additional technology into practice. They must then report technology use by March 31st, 2018 in order to receive a performance-based payment adjustment in 2019.

As these small, rural and safety-net hospitals fall behind, a digital divide emerges. These health systems will struggle to provide top-notch care in the case of a crisis, compared to other systems with EHR capabilities. Most hospitals also fail to provide sufficient patient engagement capabilities such as patient portals to view medical information and test results. Hopefully, the incentive systems in place will ease EHR and other technology adoption in small medical centers, closing the technology gap.

There is no doubt that people use technology to assist every-day life functions, and will soon expect the same from all parts of the healthcare system- including electronic health records, billing statements and payment options. All participants in the healthcare system will benefit when EHR implementation reaches 100% across all health systems, eliminating the digital divide.


Heather Turnbaugh is the Social Media and Brand Communications Coordinator at MailMyStatements. She enjoys snowboarding, working out, and napping.

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