Office of the National Coordinator for Health Information Technology: 2014 Report to Congress

This is the 2014 report to Congress from the Office of the National Coordinator (ONC) for Health Information Technology on the nation’s progress in the adoption of health information technology and related efforts to facilitate the electronic use and exchange of health information.  These annual reports are required by the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act.

In this latest report, the ONC estimates that, as of June 2014,  92 percent of eligible hospitals (over 4,500 hospitals) and 75 percent of eligible professionals (over 403,000 health care providers, primarily physicians) had received HITECH Act incentive payments through Medicare or Medicaid (some initial payments were available for obtaining, although not yet implementing an EHR).

The ONC estimates that, as of 2013, 59 percent of hospitals and 48 percent of office-based physicians had implemented at least a basic electronic health record (EHR) system, compared to 12 percent of hospitals and 22 percent of physicians in 2009, prior to the enactment of the HITECH Act.   As of 2013, even higher percentages of hospitals (94 percent) and office-based physicians (78 percent) had obtained EHRs while not yet implementing them.  Among office-based physicians who have not implemented EHRs, 73% named the cost of purchasing the system and 59% named loss of productivity as barriers to adoption.  Significantly, 46% also named finding an EHR to meet practice needs and 40% named adequacy of training as barriers to adoption.

Regional extension centers established through the HITECH Act have assisted over 150,000 providers with EHR adoption, and over 100,000 have met the HITECH Act eligibility requirements for incentive payments.  The RECs have received a one year no-cost extension to continue their work through August 2015.

Among federally qualified health centers, as of 2012, 90 percent had obtained an EHR and half had implemented at least a basic EHR.   As of 2012, 65 percent of community-based behavioral health care providers used an EHR and 20 percent of residential care facilities used EHRs.

In 2013, 70 percent of providers use an EHR to send electronic prescriptions and 57 percent of new and renewal prescriptions were in fact sent electronically.  96 percent of community pharmacies are actively participating in electronic prescribing.  In 2013, 69 percent of physicians report the capability to order lab tests electronically and 77 percent report the capability to view lab results electronically.

There still is much more progress that is needed on health information exchange.  57 percent of hospitals electronically share lab reports with providers outside their system, and 55 percent of hospitals electronically share radiology reports.  However, only 37 percent electronically share medication list with providers outside their system.   And only 24 percent of hospitals provide electronic notification to a patient’s primary care provider outside their system when the patient appears at the hospital’s emergency department.

Half of hospitals report the capability of their providers to electronically query patient health information from sources outside their hospital EHR system.  Conversely, only 14 percent of physicians are electronically sharing patient information with providers outside their system.

42 percent of providers provide their patients the capability to view online, download, or transmit health information from their EHR.

As of April 2014, the ONC had certified 1,136 EHR products, both full EHRs and modules that perform specific functions of EHRs required for HITECH Act incentive payments under the “meaningful use of certified EHRs” requirements.

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