Lower electronic health record adoption and interoperability in rural versus urban physician participants: a cross-sectional analysis from the CMS quality payment program

A. Jerrod Anzalone; Carol R. Geary; Ran Dai; Shinobu Watanabe-Galloway; James C. McClay; James R. Campbell

doi:10.1186/s12913-024-12168-5

journal article Open Access Jan 23, 2025

Lower electronic health record adoption and interoperability in rural versus urban physician participants: a cross-sectional analysis from the CMS quality payment program

A. Jerrod Anzalone Carol R. Geary Ran Dai Shinobu Watanabe-Galloway James C. McClay James R. Campbell

BMC Health Services Research Vol. 25 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1186/s12913-024-12168-5

Topics

No keywords indexed for this article. Browse by subject →

References

50

[1]

Act H. Health Information Technology for Economic and Clinical Health. 2010.

[2]

Adler-Milstein J, Everson J, Lee SY. Sequencing of EHR adoption among US hospitals and the impact of meaningful use. J Am Med Inform Assoc. 2014;21(6):984–91. 10.1136/amiajnl-2014-002708

[3]

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period. Fed Regist 2015, 80(158):49325–49886.

[4]

Congress U: HR 34. 21st Century Cures Act. 2016. In: URL https://www.congress.gov/bill/114th-congress/house-bill/34/text:2017; 2017.

[5]

2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. In. Edited by Office of the National Coordinator for Health Information Technology (ONC) DoHaHSH; 2016: 62601–62759.

[6]

Adler-Milstein J, DesRoches CM, Kralovec P, Foster G, Worzala C, Charles D, Searcy T, Jha AK. Electronic Health Record Adoption In US Hospitals: Progress Continues. But Challenges Persist Health Aff (Millwood). 2015;34(12):2174–80. 10.1377/hlthaff.2015.0992

[7]

Electronic health record adoption in US hospitals: the emergence of a digital “advanced use” divide

Julia Adler-Milstein, A Jay Holmgren, Peter Kralovec et al.

Journal of the American Medical Informatics Associ... 2017 10.1093/jamia/ocx080

[8]

Kruse CS, Kristof C, Jones B, Mitchell E, Martinez A. Barriers to electronic health record adoption: a systematic literature review. J Med Syst. 2016;40(12):252. 10.1007/s10916-016-0628-9

[9]

Vest JR, Kash BA. Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges. Milbank Q. 2016;94(1):77–108. 10.1111/1468-0009.12180

[10]

Wright A, Henkin S, Feblowitz J, McCoy AB, Bates DW, Sittig DF. Early results of the meaningful use program for electronic health records. N Engl J Med. 2013;368(8):779–80. 10.1056/nejmc1213481

[11]

Percent of Hospitals, By Type, that Possess Certified Health IT https://www.healthit.gov/data/quickstats/percent-hospitals-type-possess-certified-health-it

[12]

AHA Annual Survey Database™ Fiscal Year 2011. In.: American Hospital Association; 2008–2021.

[13]

National trends in hospital and physician adoption of electronic health records. https://www.healthit.gov/data/quickstats/adoption-electronic-health-records-hospital-service-type-2019-2021.

[14]

Sandefer RH, Marc DT, Kleeberg P. Meaningful use attestations among US hospitals: the growing rural-urban divide. Perspect Health Inf Manag. 2015;12(Spring):1f.

[15]

Kim J, Ohsfeldt RL, Gamm LD, Radcliff TA, Jiang L. Hospital characteristics are associated with readiness to attain stage 2 meaningful use of electronic health records. J Rural Health. 2017;33(3):275–83. 10.1111/jrh.12193

[16]

2021 QPP Experience Report Public Use File. In. Edited by Services CfMM; 2023.

[17]

Ochieng N, Rae M, Biniek J, Neuman T: Most office-based physicians accept new patients, including patients with Medicare and private insurance. In.; 2023.

[18]

Medicare Cf, Services M: CMS fast facts. In.: Retrieved November; 2021.

[19]

Certified Health IT Product List (CHPL) Open API. In. Edited by Technology OotNCfHI; 2023.

[20]

2021 Medicare promoting interoperability program scoring methodology fact sheet. In. Edited by (CMS) CfMMS; 2021.

[21]

Medicare Cf, Medicaid Services H: Medicare program; CY 2018 updates to the quality payment program; and quality payment program: extreme and uncontrollable circumstance policy for the transition year. Final rule with comment period and interim final rule with comment period. Federal register 2017;82(220):53568–54229.

[22]

Sittig DF, Classen DC, Singh H. Patient safety goals for the proposed Federal Health Information Technology Safety Center. J Am Med Inform Assoc. 2015;22(2):472–8. 10.1136/amiajnl-2014-002988

[23]

Defining Rural Population. https://www.hrsa.gov/rural-health/about-us/what-is-rural.

[24]

Medicare Program; Hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and final policy changes and fiscal year 2021 rates; quality reporting and medicare and medicaid promoting interoperability programs requirements for eligible hospitals and critical access hospitals. In. Edited by HHS CfMMSC, vol. CMS-1735-F; 2020.

[25]

ACO #11-Percent of Primary Care Physicians Who Successfully Attest to an EHR Incentive Program. https://www.hhs.gov/guidance/document/aco-11-percent-primary-care-physicians-who-successfully-attest-ehr-incentive-program.

[26]

Reproducible Summary Tables with the gtsummary Package

Daniel,D. Sjoberg, Karissa Whiting, Michael Curry et al.

The R Journal 10.32614/rj-2021-053

[27]

Larmarange J: ggstats: Extension to'ggplot2'for Plotting Stats. 2023. 10.32614/cran.package.ggstats

[28]

Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff (Millwood). 2011;30(3):464–71. 10.1377/hlthaff.2011.0178

[29]

Menachemi N, Collum TH. Benefits and drawbacks of electronic health record systems. Risk Manag Healthc Policy. 2011;4:47–55. 10.2147/rmhp.s12985

[30]

O’Malley AS, Grossman JM, Cohen GR, Kemper NM, Pham HH. Are electronic medical records helpful for care coordination? Experiences of physician practices. J Gen Intern Med. 2010;25(3):177–85. 10.1007/s11606-009-1195-2

[31]

Osborn CY, Mayberry LS, Wallston KA, Johnson KB, Elasy TA. Understanding patient portal use: implications for medication management. J Med Internet Res. 2013;15(7): e133. 10.2196/jmir.2589

[32]

Hillestad R, Bigelow J, Bower A, Girosi F, Meili R, Scoville R, Taylor R. Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health Aff (Millwood). 2005;24(5):1103–17. 10.1377/hlthaff.24.5.1103

[33]

Chan KS, Fowles JB, Weiner JP. Review: electronic health records and the reliability and validity of quality measures: a review of the literature. Med Care Res Rev. 2010;67(5):503–27. 10.1177/1077558709359007

[34]

Patel V, Pylypchuk Y, Henry J, Searcy T. Variation in interoperability among US non-federal acute care hospitals in 2015. ONC Data Brief 2016;37.

[35]

Lintz J. Adoption of computerized information management systems (CIMS) functions: Urban versus rural primary healthcare providers. International Journal of Healthcare Management. 2021;14(4):1237–45. 10.1080/20479700.2020.1756109

[36]

Gill E, Dykes PC, Rudin RS, Storm M, McGrath K, Bates DW. Technology-facilitated care coordination in rural areas: What is needed? Int J Med Inform. 2020;137: 104102. 10.1016/j.ijmedinf.2020.104102

[37]

Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care

Basit Chaudhry, Jerome Wang, Shinyi Wu et al.

Annals of Internal Medicine 2006 10.7326/0003-4819-144-10-200605160-00125

[38]

Hartley D. Rural health disparities, population health, and rural culture. Am J Public Health. 2004;94(10):1675–8. 10.2105/ajph.94.10.1675

[39]

Bahensky JA, Jaana M, Ward MM. Health care information technology in rural America: electronic medical record adoption status in meeting the national agenda. J Rural Health. 2008;24(2):101–5. 10.1111/j.1748-0361.2008.00145.x

[40]

Conn J. Stalled progress. EHR adoption lags for small, rural practices: studies. Mod Healthc. 2012;42(18):16.

[41]

Wittie M, Ngo-Metzger Q, Lebrun-Harris L, Shi L, Nair S. Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers. J Healthc Qual. 2016;38(1):42–51. 10.1111/jhq.12067

[42]

Bagchi AD. Expansion of telehealth across the rural–urban continuum. State and Local Government Review. 2019;51(4):250–8. 10.1177/0160323x20929053

[43]

Evaluating Telehealth Adoption and Related Barriers Among Hospitals Located in Rural and Urban Areas

Jie Chen, Aitalohi Amaize, Deanna Barath

The Journal of Rural Health 2021 10.1111/jrh.12534

[44]

Datta P, Eiland L, Samson K, Donovan A, Anzalone AJ, McAdam-Marx C. Telemedicine and health access inequalities during the COVID-19 pandemic. J Glob Health. 2022;12:05051. 10.7189/jogh.12.05051

[45]

Eiland L, Datta P, Samson K, Anzalone J, Donovan A, McAdam-Marx C. In-person and telehealth provider access and glycemic control for people with diabetes during the COVID-19 pandemic. J Diabetes Sci Technol. 2023;17(4):895–900. 10.1177/19322968231162866

[46]

Holmgren AJ, Apathy NC, Adler-Milstein J. Barriers to hospital electronic public health reporting and implications for the COVID-19 pandemic. J Am Med Inform Assoc. 2020;27(8):1306–9. 10.1093/jamia/ocaa112

[47]

Fraze TK, Lewis VA, Wood A, Newton H, Colla CH. Configuration and delivery of primary care in rural and urban settings. J Gen Intern Med. 2022;37(12):3045–53. 10.1007/s11606-022-07472-x

[48]

Jiang J, Qi K, Bai G, Schulman K. Pre-pandemic assessment: a decade of progress in electronic health record adoption among US hospitals. Health Affairs Scholar. 2023;1(5):qxad056. 10.1093/haschl/qxad056

[49]

MIPS Participation Fact Sheet. https://www.cms.gov/files/document/qppmipsparticipationfactsheetpdf.

[50]

Survey Emphasizes Scale and Significance of the RHC Program. https://www.narhc.org/News/30432/Survey-Emphasizes-Scale-and-Significance-of-the-RHC-Program.

Cited By

21

The landscape of AI implementation in US hospitals

Yeon-Mi Hwang, Madelena Y. Ng · 2026

Nature Health

Digital health transformation and innovation behavior: examining the role of technological readiness and dynamic capabilities in public hospitals

Joather Alwali, Wafaa Alwali · 2025

International Journal of Innovation...

Use of Risk Assessment to Guide Decision-Making for Blood Pressure Management in the Primary Prevention of Cardiovascular Disease: A Scientific Statement From the American Heart Association and American College of Cardiology

Sadiya S. Khan, Marwah Abdalla · 2025

Hypertension

Metrics

21

Citations

50

References

Details

Published: Jan 23, 2025
Vol/Issue: 25(1)
License: View

Authors

Shinobu Watanabe-Galloway

Funding

National Cancer Institute Award: P30 CA036727

National Institute of General Medical Sciences Award: U54 GM115458

Cite This Article

A. Jerrod Anzalone, Carol R. Geary, Ran Dai, et al. (2025). Lower electronic health record adoption and interoperability in rural versus urban physician participants: a cross-sectional analysis from the CMS quality payment program. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-024-12168-5

Lower electronic health record adoption and interoperability in rural versus urban physician participants: a cross-sectional analysis from the CMS quality payment program

You May Also Like