J Am Med Inform Assoc - Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program.

Tópicos

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Resumo

JECTIVE: To identify area-level correlates of electronic health record (EHR) adoption and meaningful use (MU) among primary care providers (PCPs) enrolled in the Regional Extension Center (REC) Program.MATERIALS AND METHODS: County-level data on 2013 EHR adoption and MU among REC-enrolled PCPs were obtained from the Office of the National Coordinator for Health Information Technology and linked with other county-level data sources including the Area Resource File, American Community Survey, and Federal Communications Commission's broadband availability database. Hierarchical models with random intercepts for RECs were employed to assess associations between a broad set of area-level factors and county-level rates of EHR adoption and MU.RESULTS: Among the 2715 counties examined, the average county-level EHR adoption and MU rates for REC-enrolled PCPs were 87.5% and 54.2%, respectively. Community health center presence and Medicaid enrollment concentration were positively associated with EHR adoption, while metropolitan status and Medicare Advantage enrollment concentration were positively associated with MU. Health professional shortage area status and minority concentration were negatively associated with EHR adoption and MU.DISCUSSION: Increased financial incentives in areas with greater concentrations of Medicaid and Medicare enrollees may be encouraging EHR adoption and MU among REC-enrolled PCPs. Disparities in EHR adoption and MU in some low-resource and underserved areas remain a concern.CONCLUSIONS: Federal efforts to spur EHR adoption and MU have demonstrated some early success; however, some geographic variations in EHR diffusion indicate that greater attention needs to be paid to ensuring equitable uptake and use of EHRs throughout the US.

Resumo Limpo

jectiv identifi arealevel correl electron health record ehr adopt meaning use mu among primari care provid pcps enrol region extens center rec programmateri method countylevel data ehr adopt mu among recenrol pcps obtain offic nation coordin health inform technolog link countylevel data sourc includ area resourc file american communiti survey feder communic commiss broadband avail databas hierarch model random intercept rec employ assess associ broad set arealevel factor countylevel rate ehr adopt muresult among counti examin averag countylevel ehr adopt mu rate recenrol pcps respect communiti health center presenc medicaid enrol concentr posit associ ehr adopt metropolitan status medicar advantag enrol concentr posit associ mu health profession shortag area status minor concentr negat associ ehr adopt mudiscuss increas financi incent area greater concentr medicaid medicar enrolle may encourag ehr adopt mu among recenrol pcps dispar ehr adopt mu lowresourc underserv area remain concernconclus feder effort spur ehr adopt mu demonstr earli success howev geograph variat ehr diffus indic greater attent need paid ensur equit uptak use ehr throughout us

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