ArticleJournal of the American Medical Informatics Association : JAMIA2020
Reconsidering hospital EHR adoption at the dawn of HITECH: implications of the reported 9% adoption of a "basic" EHR.
Article in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Semantics-driven improvements in electronic health records data quality: a systematic review.BMC medical informatics and decision making · 2025Pooled it
- The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- Trends and Sex-Specific Rates of Obesity and Severe Obesity in US Hospitalized Adults, 2012-2021.Journal of general internal medicine · 2026Article
- Toward a National Health Digital and Data Architecture: Laying the Foundation for Digital Transformation: Commission on Investment Imperatives for a Healthy Nation.NAM perspectives · 2026Review
- Adoption of Machine Learning in US Hospital Electronic Health Record Systems: Retrospective Observational Study.Journal of medical Internet research · 2025Observational
- Should we synthesize more than we need: impact of synthetic data generation for high-dimensional cross-sectional medical data.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- New indices to track interoperability among US hospitals.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Trending in the right direction: critical access hospitals increased adoption of advanced electronic health record functions from 2018 to 2023.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- User Experiences of Transitioning From a Homegrown Electronic Health Record to a Vendor-Based Product in the Department of Veterans Affairs: Qualitative Findings From a Mixed Methods Evaluation.JMIR formative research · 2024Article
- Digital Maturity as a Predictor of Quality and Safety Outcomes in US Hospitals: Cross-Sectional Observational Study.Journal of medical Internet research · 2024Observational
- Medical Informatics Operating Room Vitals and Events Repository (MOVER): a public-access operating room database.JAMIA open · 2023Article
- Pre-pandemic assessment: a decade of progress in electronic health record adoption among U.S. hospitals.Health affairs scholar · 2023Article
- Systematized Nomenclature of Medicine-Clinical Terminology (SNOMED CT) Clinical Use Cases in the Context of Electronic Health Record Systems: Systematic Literature Review.JMIR medical informatics · 2023Review
- Higher Electronic Health Record Functionality Is Associated with Lower Operating Costs in Urban-but Not Rural-Hospitals.Applied clinical informatics · 2022Article
- Clinical deployment environments: Five pillars of translational machine learning for health.Frontiers in digital health · 2022Review
- Learning health systems: Driving real-world impact in mental health and substance use disorder research.FASEB bioAdvances · 2021Article
- Clinical Note Section Detection Using a Hidden Markov Model of Unified Medical Language System Semantic Types.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2021Article
- Celebrating G. Octo Barnett, MD.Journal of the American Medical Informatics Association : JAMIA · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
3 authors.
Funding
Abstract
objectiveIn 2009, a prominent national report stated that 9% of US hospitals had adopted a "basic" electronic health record (EHR) system. This statistic was widely cited and became a memetic anchor point for EHR adoption at the dawn of HITECH. However, its calculation relies on specific treatment of the data; alternative approaches may have led to a different sense of US hospitals' EHR adoption and different subsequent public policy. MATERIALS AND
methodsWe reanalyzed the 2008 American Heart Association Information Technology supplement and complementary sources to produce a range of estimates of EHR adoption. Estimates included the mean and median number of EHR functionalities adopted, figures derived from an item response theory-based approach, and alternative estimates from the published literature. We then plotted an alternative definition of national progress toward hospital EHR adoption from 2008 to 2018.
resultsBy 2008, 73% of hospitals had begun the transition to an EHR, and the majority of hospitals had adopted at least 6 of the 10 functionalities of a basic system. In the aggregate, national progress toward basic EHR adoption was 58% complete, and, when accounting for measurement error, we estimate that 30% of hospitals may have adopted a basic EHR. DISCUSSION: The approach used to develop the 9% figure resulted in an estimate at the extreme lower bound of what could be derived from the available data and likely did not reflect hospitals' overall progress in EHR adoption.
conclusionThe memetic 9% figure shaped nationwide thinking and policy making about EHR adoption; alternative representations of the data may have led to different policy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.