title: Rate of electronic health record adoption in South Korea: A nation-wide survey.
abstract: The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US.
  
  
  
  All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities.
  
  
  
  EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%).
  
  
  
  The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009.
  
  
  
  The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries.
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Young-Gun
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Kyoungwon
authors.initials: K
authors.lastname: Jung
authors.affiliation: Health Insurance Review & Assessment Service, Seoul, South Korea.
authors.forename: Young-Taek
authors.initials: YT
authors.lastname: Park
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Dahye
authors.initials: D
authors.lastname: Shin
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: Soo Yeon
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea. Electronic address: d.yoon.ajou@gmail.com.
authors.forename: Dukyong
authors.initials: D
authors.lastname: Yoon
authors.affiliation: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea; Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea. Electronic address: veritas@ajou.ac.kr.
authors.forename: Rae Woong
authors.initials: RW
authors.lastname: Park
mesh_terms: D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D011216:Practice Management, Medical; D056910:Republic of Korea
keywords: Electronic health records; Hospital information systems; Medical order entry systems