title: Electronic medical record systems in critical access hospitals: leadership perspectives on anticipated and realized benefits.
abstract: The growth of electronic medical records (EMRs) is driven by the belief that EMRs will significantly improve healthcare providers' performance and reduce healthcare costs. Evidence supporting these beliefs is limited, especially for small rural hospitals. A survey that focused on health information technology (HIT) capacity was administered to all hospitals in Iowa. Structured interviews were conducted with the leadership at 15 critical access hospitals (CAHs) that had implemented EMRs in order to assess the perceived benefits of operational EMRs. The results indicate that most of the hospitals implemented EMRs to improve efficiency, timely access, and quality. Many CAH leaders also viewed EMR implementation as a necessary business strategy to remain viable and improve financial performance. While some reasons reflect external influences, such as perceived future federal mandates, other reasons suggest that the decision was driven by internal forces, including the hospital's culture and the desires of key leaders to embrace HIT. Anticipated benefits were consistent with goals; however, realized benefits were rarely obvious in terms of quantifiable results. These findings expand the limited research on the rationale for implementing EMRs in critical access hospitals.
authors.affiliation: The Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: Troy R
authors.initials: TR
authors.lastname: Mills
authors.forename: Jared
authors.initials: J
authors.lastname: Vavroch
authors.forename: James A
authors.initials: JA
authors.lastname: Bahensky
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Ward
mesh_terms: D057171:American Recovery and Reinvestment Act; D004059:Diffusion of Innovation; D004636:Emergency Service, Hospital / Q000191:economics / Q000458:organization & administration*; D005377:Financial Management, Hospital / Q000458:organization & administration; D006751:Hospital Information Systems / Q000191:economics / Q000458:organization & administration*; D006780:Hospitals, Rural / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007484:Iowa; D007857:Leadership; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D012041:Regional Medical Programs / Q000458:organization & administration; D018570:Risk Assessment; D014481:United States