Chartbook on Care Coordination

• Electronic health records (EHRs) have the potential to improve the quality and safety of health care.

Benefits of Electronic Health Records

• Evidence has shown that the adoption and effective use of health information technology can:
  • Help reduce medical errors and adverse events.
  • Enable better documentation and file organization.
  • Provide patients with information that assists their adherence to medication regimens and scheduled appointments.
  • Assist doctors in tracking their treatment protocols (IOM, 2010).

Electronic Health Record Measures

• Measures of the use of electronic health records include:
  • Patients who reported that it was very important for them to get their own medical information electronically.
  • Patients who reported that it was very important that doctors and other health providers be able to share their medical information with other providers electronically.
  • Hospitals with fully implemented electronic medical record system.
  • Hospitals with computerized systems that allow for electronic clinical documentation.
  • Hospitals with computerized systems that allow for results viewing.
  • Hospitals with computerized systems that allow for decision support.
  • Hospitals with computerized systems that allow for computerized provider order entry (CPOE).

Patients Who Said It Was Important To Get Their Medical Information Electronically

Patients who reported that it was important for them to get their own medical information electronically, by age and residence location, 2008 and 2012-2013

Key: MSA = metropolitan statistical area.
Source: Health Information National Trends Survey. Iterations included in this table are HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Accessible at http://hints.cancer.gov.

• In 2013, 64.9% of patients reported that it was very important for them to get their own medical information electronically, a significant increase from 58.3% in 2008.
• In all 3 years, patients age 65 and over were less likely than patients ages 18-34 to report that it was very important for them to get their own medical information electronically.
• In all years, residents of nonmetropolitan areas were less likely than residents of metropolitan areas to report that it was very important for them to get their own medical information electronically.

Patients who reported that it was important for them to get their own medical information electronically, by ethnicity and education, 2008 and 2012-2013

Source: Health Information National Trends Survey. Iterations included in this table are; HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Accessible at  http://hints.cancer.gov.
Note: White, Black, and Asian are non-Hispanic. Hispanic includes all races.

• From 2008 to 2013, the percentage of Black patients who reported that it was very important to be able to get their medical information electronically increased from 54.1%.
• In all 3 years, patients who were college graduates were more likely than patients with less than a high school education and high school graduates to report that it was very important to be able to get their medical information electronically. From 2008 to 2013, the percentage of Black patients who reported that it was very important to be able to get their medical information electronically increased from 54.1% to 67.2%, for White patients from 58.8% to 66.4% and for Hispanic patients from 57.1% to 60.2%.

Patients Who Said It Was Important for Health Providers To Be Able To Share Patient Information With Other Providers Electronically

Patients who reported that it was very important that doctors and other health providers be able to share their medical information with other providers electronically, by age and residence location, 2008 and 2012-2013

Key: MSA = metropolitan statistical area.
Source: Health Information National Trends Survey. Iterations included in this table are; HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Accessible at  http://hints.cancer.gov.

• In 2013, 63.0% of patients reported that it was very important that health care providers be able to share their medical information with other providers electronically, a significant increase from 46.7% in 2008.
• In all 3 years, patients age 65 and over were more likely than patients ages 18-34 to report that it was very important that health care providers be able to share their medical information electronically.
• From 2008 to 2013, the percentage of residents of both metropolitan and nonmetropolitan areas who reported that it was very important that health care providers be able to share their medical information electronically improved significantly.

Patients who reported that it was very important that doctors and other health providers be able to share their medical information with other providers electronically, by ethnicity and education, 2008 and 2012-2013

Source: Health Information National Trends Survey. Iterations included in this table are; HINTS 3, HINTS 4 Cycle 1, and HINTS 4 Cycle 2. Accessible at  http://hints.cancer.gov.
Note: White, Black, and Asian are non-Hispanic. Hispanic includes all races.

• From 2008 to 2013, the percentage of Black patients who reported that it was very important that providers be able to share their medical information with other providers electronically increased from 41.8% to 59.7%. White patients showed an increase from 48.4% to 65.6% and Hispanic patients increased from 45.1 to 59.9%.
• In 2013, White patients were more likely than Black patients to report that it was very important that providers be able to share their medical information electronically.
• From 2008 to 2013, the percentage of patients with less than a high education who reported that it was very important that providers be able to share their medical information electronically increased from 43.7% to 57.7%, high school graduates increased from 43.7% to 63.7%, patients with some college increased from 46.8% to 63.3%, and college graduates increased from 52.2% to 63.6%.

Hospitals With Electronic Medical Record Systems

Hospitals with a fully implemented electronic medical record system, by State, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, the percentage of hospitals with a fully implemented electronic medical record system was less than 34.2% in States in the lowest quartile and above 50.0% in States in the highest quartile.
• States in the South tended to be in the lower quartiles while States in the Midwest and West tended to be in the higher quartiles.

Hospitals With Computerized Systems That Allow for Electronic Documentation

Hospitals with computerized systems that allow for electronic clinical documentation, by component, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for electronic clinical documentation, the percentage with each component was as follows:
  • Patient demographics, 89.9%.
  • Medication lists, 77.7%.
  • Nursing notes, 74.6%.
  • Advance directives, 71.5%.
  • Discharge summaries, 70.9%.
  • Problem lists, 68.9%.
  • Physician notes, 47.5%.

Hospitals with computerized systems that allow for electronic clinical documentation with a component for physician notes, by hospital control and hospital type, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, 91.9% of hospitals run by Federal Government, 53.1% of not-for-profit, 43.8% of non-Federal Government, and 25.2% of for-profit hospitals had a component for physician notes.
• In 2012, 68.1% of children's general, 49.7% of general medical and surgical, 33.7% of rehabilitation, 31.2% of acute long-term care, and 28% of psychiatric hospitals had a component for physician notes.

Hospitals With Computerized Systems That Allow for Results Viewing

Hospitals with computerized systems that allow for results viewing, by component, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for results viewing, the percentage with each component was as follows:
  • Laboratory reports, 86.2%.
  • Radiology reports, 85.0%.
  • Radiology images, 82.3%.
  • Diagnostic test results, 73.9%.
  • Consultant reports, 69.6%.
  • Diagnostic test images, 66.7%.

Hospitals with computerized systems that allow for results viewing with a component for consultant reports, by region and bed size, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for results viewing, the percentage with a component for consultant reports was highest in the Midwest (73.1%). Seventy percent of hospitals in the Northeast, 69.0% of hospitals in the West, and 66.1% of hospitals in the South had a component for consultant reports.
• In 2012, 86.1% of hospitals with 400 or more beds, 77.7% of hospitals with 100-399 beds, and 59.4% of hospitals with less than 100 beds had a component for consultant reports.

Hospitals With Computerized Systems That Allow for Decision Support

Hospitals with computerized systems that allow for decision support, by component, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for decision support, the percentage with each component was as follows:
  • Drug allergy alerts, 79.0%.
  • Drug-drug interaction alerts, 78.3%.
  • Drug-lab interaction alerts, 66.6%.
  • Drug dosing support, 62.9%.
  • Clinical reminders, 57.3%.
  • Clinical guidelines, 53.8%.

Hospitals with computerized systems that allow for decision support with a component for drug-drug interaction alerts, by hospital control and hospital type, 2012

Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, 96.7% of hospitals run by the Federal Government, 86.1% of not-for-profit, 73.7% of non-Federal Government, and 51.9% of for-profit hospitals had a component for drug-drug interaction alerts.
• In 2012, 84.0% of children’s general, 83.1% of general medical and surgical, 49.4% of acute long-term care, 46.8% of rehabilitation, and 44.2% of psychiatric hospitals had a component for drug-drug interaction alerts.

Hospitals With Computerized Systems That Allow for CPOE

Hospitals with computerized systems that allow for CPOE, by component, 2012

Key: CPOE = computerized provider order entry.
Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for computerized provider order entry, the percentage with each component was as follows:
  • Nursing orders, 63.6%.
  • Laboratory tests, 62.8%.
  • Radiology tests, 62.4%.
  • Consultant requests, 56.8%.

Hospitals with computerized systems that allow for CPOE with a component for radiology tests, by region and bed size, 2012

Key: CPOE = computerized provider order entry.
Source: American Hospital Association (AHA), Information Technology Supplement, 2012.

• In 2012, among hospitals with computerized systems that allow for CPOE, the West had the highest percentage with a component for radiology tests (65.4%). Approximately 65% of hospitals in the Northeast and Midwest and 57.9% of hospitals in the South had a component for radiology tests.
• In 2012, 84% of hospitals with 400 or more beds, 65.4% of hospitals with 100-399 beds, and 55.1% of hospitals with less than 100 beds had a component for radiology tests.

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