* Less than 2 percent have comprehensive systems
* Cost biggest barrier to adoption, hospitals say
* Urban hospitals more likely to be have IT records
CHICAGO, March 25 (Reuters) - Less than 2 percent of U.S. hospitals have adopted fully functional electronic medical records, with most citing cost as the biggest barrier, U.S. researchers said on Wednesday.
“The data collectively show we are at a very early stage in adoption, a very low stage compared to other countries,” said Harvard’s Dr. David Blumenthal, who last week was tapped to lead President Barack Obama’s $19 billion push to increase the use of information technology in healthcare.
Obama has made electronic medical records a central piece of his plan to cut costs out of a U.S. healthcare system that consistently ranks lower in quality measures than other rich countries.
Blumenthal said the study, published in the New England Journal of Medicine, clearly shows the United States has room to improve. He said financial incentives in the economic stimulus bill should help, given that most hospitals reporting that cost as their biggest stumbling block.
The study by Blumenthal, Dr. Ashish Jha of the Harvard School of Public Health, and others, is based on data collected in 2008 from nearly 3,000 hospitals.
It was designed to get a baseline reading on how widely U.S. hospitals have adopted electronic medical records, which promise to reduce medical errors and improve health quality.
“Right now, very few hospitals in America have a comprehensive electronic health record,” Jha told the briefing. “Only about 1 in 10 meet the definition of a basic electronic health record.”
A study by the same group last year found just 17 percent of American doctors have switched from conventional paper records to electronic health records, and only 4 percent had fully-functional systems that help them make decisions about patient care or order tests.
The group defined a comprehensive system as one that collects doctor and nurse notes, orders tests, helps doctors make decisions about care and is available in every unit of the hospital. They considered a basic system as one that included doctor or nurse notes and was used in at least one care unit, such as radiology.
They found that larger, urban teaching hospitals are more likely to have electronic health records than other hospitals, in part because they are better funded.
Health information systems cost between $20 million to $100 million, depending on hospital size and complexity of the system. And many hospitals in the survey said they had no way of recouping that investment.
Blumenthal said funding purchases is a barrier the stimulus money can address. “For physicians, the cost of adoption could be more or less completely covered. For hospitals, perhaps they would be covered for modest-sized institutions,” he said.
He said the bill would also offer funding for training and technical support, which many smaller institutions lack.
Interoperability -- systems that can easily share information between departments -- was another big hurdle, the study found. Many hospitals have a hodgepodge of systems for different departments, but none of the pieces fit together.
“That is one of the reasons hospitals have been slower” to adopt such systems, Blumenthal said, adding that standards requiring electronic medical records to be interoperable was “a widely held core goal.”
He said said the push for electronic health records needs to be part of an overall transformation of healthcare in the United States, including how doctors and hospitals are paid.
“It would be wrong to see this as a technology that can be adopted solely on its own. It needs to be adopted in an environment that supports it,” he said.
Editing by Philip Barbara
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