201875 Geographic differences in electronic health records implementation: The case of Alabama hospitals

Monday, November 9, 2009

Shannon H. Houser, PhD , Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Lucretia A. Johnson, RHIA , Quadra Med Corporation, Birmingham, AL
Robert Weech-Maldonado, MBA PhD , Department of Health Services Administration, The University of Alabama at Birmingham, Birmingham, AL
Background: Rural areas in Alabama have a high concentration of African Americans, and experience disproportionately higher rates of chronic illness and mortality rates. Electronic Health Records (EHR) usage have potential benefits of improving communication between and among providers, helping to ensure continuity of health care, improving quality of care, and hence reducing health disparities in rural populations.

Objectives: 1) to assess the rural and urban differences perceived barriers, benefits, and driving factors in EHR implementation among Alabama hospitals; 2) to discuss the implications of exiting differences in EHR usage and the role of EHR in reducing geographic disparities.

Methods: A cross-sectional self-completed questionnaire was distributed to all health information management directors in 131 Alabama hospitals. Multivariate logistic analyses were used to analyze differences between rural and urban EHR usage and perceived barriers and benefits.

Results: Of 91 respondents, 58% were rural hospitals. Fewer rural hospitals (8%) have implemented EHR when compared with urban hospitals (18%). Rural hospitals were more likely than urban hospitals to report lack of support from medical staff (O.R.= 2.67) as a barrier to EHR implementation, but less likely to consider cost reduction (O.R.= 0.43) or meeting JCAHO/NCQA regulatory requirements (O.R.= 0.39) as driving factors of EHR implementation.

Discussion: Promotion of EHR implementation in rural areas is a challenging but necessary task that has potential implications of reducing health disparities between rural and urban populations. Understanding the existing differences between rural and urban areas in perceived barriers and driving factors of EHR implementation can facilitate policy interventions.

Learning Objectives:
At the conclusion of the session, the audience will be able to: •Identify geographic differences in electronic health records implementation. •Assess barriers and benefits associated with electronic health records implementation. •Discuss implications of the barriers and facilitate policy interventions.

Keywords: Health Information Systems, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Shannon Houser, Ph.D., MPH, RHIA, is an assistant professor in the department of Health Services Administration of the University of Alabama at Birmingham. Her research interests consist of electronic health records implementation and evaluation, the impact of data collection and management on research outcomes, and establish the role of health information management professionals in biomedical research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.