title: Meaningful Use Attestations among US Hospitals: The Growing Rural-Urban Divide.
abstract: The purpose of this study was to assess EHR Incentive Program attestations of eligible US hospitals across geography and hospital type. The proportions of attestations were compared between metropolitan, micropolitan, and rural hospitals and by whether a hospital was critical access or prospective payment system. From 2011 until December 2013, rural and critical access hospitals were attesting to meaningful use and receiving federal incentive payments at a significantly lower proportion than their urban counterparts. The data suggest that the digital divide between urban and rural hospitals that are adopting electronic health records and using the technology effectively is widening. These findings illustrate that the needs of rural hospitals currently and into the future are different than urban hospitals, and the meaningful use program does not appear to provide the resources needed to propel these rural hospitals forward.
authors.affiliation: Department of Health Informatics and Information Management at the College of St. Scholastica in Duluth, MN.
authors.forename: Ryan H
authors.initials: RH
authors.lastname: Sandefer
authors.affiliation: Department of Health Informatics and Information Management at the College of St. Scholastica in Duluth, MN.
authors.forename: David T
authors.initials: DT
authors.lastname: Marc
authors.affiliation: Stratis Health in Bloomington, MN.
authors.forename: Paul
authors.initials: P
authors.lastname: Kleeberg
mesh_terms: D057286:Electronic Health Records; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D062527:Meaningful Use / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D009042:Motivation; D011446:Prospective Studies; D012111:Residence Characteristics; D014481:United States
keywords: Meaningful use; critical access hospitals; rural; urban