title: Progress and challenges: implementation and use of health information technology among critical-access hospitals.
abstract: Despite major national investments to support the adoption of health information technology (IT), concerns persist that barriers are inhibiting that adoption and the use of advanced health IT capabilities in rural areas in particular. Using a survey of Medicare-certified critical-access hospitals, we examined electronic health record (EHR) adoption, key EHR functionalities, telehealth, and teleradiology, as well as challenges to EHR adoption. In 2013, 89 percent of critical-access hospitals had implemented a full or partial EHR. Adoption of key EHR capabilities varied. Critical-access hospitals that had certain types of technical assistance and resources available to support health IT were more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use, compared to other hospitals in the survey. It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader health care system.
authors.affiliation: Meghan Hufstader Gabriel (meghan.gabriel@hhs.gov) is an economist in the Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services (HHS), in Washington, D.C.
authors.forename: Meghan Hufstader
authors.initials: MH
authors.lastname: Gabriel
authors.affiliation: Emily B. Jones was a public health analyst at the ONC when this article was written. She is a social science analyst in the Office of the Assistant Secretary of Planning and Evaluation, HHS.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Jones
authors.affiliation: Leila Samy is the rural health information technology coordinator at the ONC.
authors.forename: Leila
authors.initials: L
authors.lastname: Samy
authors.affiliation: Jennifer King is chief of the Research and Evaluation Branch at the ONC.
authors.forename: Jennifer
authors.initials: J
authors.lastname: King
mesh_terms: D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006284:Health Plan Implementation; D006297:Health Services Accessibility / Q000458:organization & administration; D006739:Hospital Administration; D006801:Humans; D008490:Medical Informatics / Q000639:trends*; D006278:Medicare / Q000191:economics; D012424:Rural Population; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000191:economics; D014481:United States
keywords: Access To Care; Hospitals; Information Technology; Rural Health Care; Special Populations