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Health IT adoption rates among rural physicians uneven

Although rural hospitals and physicians have adopted health information technology at a similar or greater rate as their urban counterparts, its use varied dramatically among rural providers, who were also more likely to skip a year of declaring they have met meaningful-use requirements, according to a study published in Health Affairs.

“The recent increase in health information technology (IT) adoption has led to fears that some providers and hospitals may be left behind as more advanced health IT use becomes required for health care delivery and payment reform,” Dawn M. Heisey-Grove, BS, MPH, public health analyst at the Office of the National Coordinator for Health Information Technology, HHS, in Washington, D.C., wrote. “Because health IT adoption and use can place significant technical and financial strain on hospitals and practices, the concern regarding a ‘digital divide’ is particularly prevalent for traditionally under-resourced hospitals and providers, such as those in rural care settings.”

To study the adoption rates and use of health IT among rural providers, and to examine how initial IT adoption and meaningful use varied between rural and urban hospitals and physicians, Heisey-Grove analyzed data from the 2013 National Electronic Health Records Survey, conducted by the National Center for Health Statistics. She also drew data from the Medicare and Medicaid incentive programs between 2011 and 2014.

Heisey-Grove’s analyses contained data on 548,961 providers and hospitals. Electronic health information exchange was based on 2014 Medicare attestation and payment data, and included electronic immunization information systems reporting; electronic transmission of summaries of care; and patients’ viewing, downloading or transmitting of their electronic health information. Locations were labeled rural if they were outside of metropolitan counties, using the Health Resources and Services Administration’s 2012 to 2013 area resources file.

According to Heisey-Grove, 82.3% of rural physicians in 2013 had adopted an electronic health records system, compared with 78% of urban physicians. In addition, by the end of 2014, 41.9% of rural providers had been registered with the Medicaid incentive program compared with 31.9% of urban providers. Meaningful-use achievement was highest among rural podiatrists at 91%, followed by rural optometrists at 87.8%, whereas rural dentists had the lowest rate, with 9.5%. In all, 74.4% of rural physicians had reported meaningful use. Receiving technical assistance from a Regional Extension Center, provider and specialty type, and practice size were associated with meaningful use of electronic health records among rural physicians. However, 38% of rural Medicare-registered providers, after achieving initial meaningful use between 2011 and 2013, skipped at least 1 subsequent year between 2012 and 2014, compared to 34.9% of urban providers who similarly skipped at least 1 year.

“This study demonstrates that although rural providers’ overall initial health IT adoption rates were higher than those of urban providers, substantial adoption disparities exited within the rural community,” Heisey-Grove wrote. “Technical assistance from Regional Extension Centers played a major role in helping rural providers achieve meaningful use. Rural providers and hospitals, however, were more likely to skip subsequent years of meaningful-use achievement and may require additional assistance to support their ongoing use of health IT and sustain delivery and payment reform efforts.” – by Jason Laday

Disclosure: Heisey-Grove reports no relevant financial disclosures.