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This data brief from the Office of National Coordinator for Health IT reports on the interoperability of electronic health record systems at U.S. hospitals based on data from the 2014 American Hospital Association Annual Survey Information Technology Supplement.  All non-federal acute care general medical and surgical, general children’s, and cancer hospitals owned by private/not-for-profit, investor-owned/for-profit, or state/local government and located within the 50 states and District of Columbia were surveyed.  The response rate was 60%, and the data was weighted and adjusted based on hospital characteristics (size, ownership, teaching status, system membership, urban status, region, etc.)

While 78% of responding hospitals sent patient summary of care records to providers outside their hospital, only 56% received such records, and only 40% electronically integrated patient summary of care records received from providers outside their hospital into their electronic health record system without the need for manual entry.  Nearly half (48%) of the responding hospitals reported that their providers electronically searched (queried) for their patients’ health information from sources outside their hospital.

Hospitals are more likely to send patient summary of care records to other hospitals (49%) and to ambulatory care providers outside their hospital  (50%) than to long-term care providers (42%) and behavioral health providers (28%).   Similarly, hospitals are more likely to receive patient summary of care records from other hospitals (31%) and from ambulatory care providers outside their hospital  (29%) than from long-term care providers (17%) and behavioral health providers (16%).

While almost all U.S. hospitals have implemented some form of electronic health record system, 14% still only send patient summary of care records with providers outside their hospital through non-electronic formats (mail, fax, eFax) and 26% can only receive such records through non-electronic formats.

The most frequent barriers to increased interoperability were the availability of electronic health record capabilities among external providers (59%), difficulty in finding providers’ electronic address (45%), cumbersome workflow (30%), lack of usefulness of summary of care records (26%), additional costs for electronic exchange (25%), and difficulty in matching or identifying patients (24%).

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