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. 2013 Mar-Apr;20(2):227-32.
doi: 10.1136/amiajnl-2011-000769. Epub 2012 Aug 22.

Changes to the electronic health records market in light of health information technology certification and meaningful use

Joshua R Vest  1 , Jangho Yoon, Brian H Bossak
Affiliations

Changes to the electronic health records market in light of health information technology certification and meaningful use

Joshua R Vest et al. J Am Med Inform Assoc. 2013 Mar-Apr.

Abstract

Background: Health information technology (HIT) certification and meaningful use are interventions encouraging the adoption of electronic health records (EHRs) in the USA. However, these initiatives also constitute a significant intervention which will change the structure of the EHR market.

Objective: To describe quantitatively recent changes to both the demand and supply sides of the EHR market.

Materials and methods: A cohort of 3447 of hospitals from the HIMSS Analytics Database (2006-10) was created. Using hospital referral regions to define the local market, we determined the percentage of hospitals using paper records, the number of vendors, and local EHR vendor competition using the Herfindahl-Hirschman Index. Changes over time were assessed using a series of regression equations and geographic information systems analyses.

Results: Overall, there was movement away from paper records, upward trends in the number of EHR vendors, and greater competition. However, changes differed according to hospital size and region of the country. Changes were greatest for small hospitals, whereas competition and the number of vendors did not change dramatically for large hospitals.

Discussion: The EHR market is changing most dramatically for those least equipped to handle broad technological transformation, which underscores the need for continued targeted support. Furthermore, wide variations across the nation indicate a continued role for states in the support of EHR utilization.

Conclusion: The structure of the EHR market is undergoing substantial changes as desired by the proponents and architects of HIT certification and meaningful use. However, these transformations are not uniform for all hospitals or all the country.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Change in the number of electronic health record vendors within healthcare referral regions, 2006–10.
Figure 2
Figure 2
Change in the Herfindahl–Hirschman Index for the electronic health record market at the healthcare referral region level, 2006–10.
Figure 3
Figure 3
Percentage of hospitals relying on paper records at the healthcare referral region level, 2010.
See this image and copyright information in PMC

References

    1. Ford EW, Menachemi N, Phillips MT. Predicting the adoption of electronic health records by physicians: when will health care be paperless? J Am Med Inform Assoc 2006;13:106–12 - PMC - PubMed
    1. Kleinke JD. Dot-Gov: market failure and the creation of a national health information technology system. Health Aff 2005;24:1246–62 - PubMed
    1. Middleton B. Achieving U.S. health information technology adoption: the need for a third hand. Health Aff 2005;24:1269–72 - PubMed
    1. Certification Commission for Health Information Technology. Organization and Governance. 2011. http://www.cchit.org/about/organization (accessed 8 Aug 2011).
    1. Classen DC, Avery AJ, Bates DW. Evaluation and certification of computerized provider order entry systems. J Am Med Inform Assoc 2007;14:48–55 - PMC - PubMed