Association between cost as the primary barrier to achieving meaningful use criteria and implementation of select electronic health record meaningful use functions

Background: Hospitals have been incentivized to achieve meaningful use (MU) of certified electronic health record (EHR) technology in order to achieve a host of potential benefits.

Objective: Despite the incentives and the perceived benefits of EHR use, hospitals frequently cite cost as a barrier to implementation. The purpose of this study is to determine the relationship between the identification of cost as the single largest barrier to achieving MU and implementation of select MU functions.

Methods: The Nationwide Inpatient Sample 2010 (hospital characteristics used as covariates) was merged with the American Hospital Association Information Technology Supplement (AHA-IT) 2010 (n=307). The key independent variable was created using the AHA-IT question that asked hospitals to indicate the single largest barrier to reaching MU, three of the eleven possible responses were associated with cost. The dependent variable was the average implementation of seven EHR functions cited as MU requirements.

Results: A multivariate regression detected a significant positive relationship (α = 0.05) between the identification of cost (=0.7404, SE=0.04, p≤0.0001), as the single largest barrier to achieving MU and implementation of select MU functions.

Discussion: The analysis revealed the cost of obtaining and maintaining select MU standards to be the single largest barrier in achieving the MU criteria. The data was collected one year prior to Stage 1 of MU. These findings prompt further investigation into determining if post-stage 1 of MU if hospitals still consider cost to be a barrier to achieving MU.