Assessing the level of healthcare information technology adoption in the United States: a snapshot.
BACKGROUND
Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap.


METHODS
We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages.


RESULTS
Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity.


CONCLUSIONS
Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.
Poon
Eric G
EG
Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA. epoon@partners.org
Jha
Ashish K
AK
Christino
Melissa
M
Honour
Melissa M
MM
Fernandopulle
Rushika
R
Middleton
Blackford
B
Newhouse
Joseph
J
Leape
Lucian
L
Bates
David W
DW
Blumenthal
David
D
Kaushal
Rainu
R
D001291:Attitude of Health Personnel; D001900:Boston; D003120:Colorado; D032921:Consensus; D003697:Delphi Technique; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D006801:Humans; D007256:Information Systems / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D017751:Safety Management; D018511:Systems Integration; D014481:United States