HITECH Act Drove Large Gains In Hospital Electronic Health Record Adoption

TLDR

The extent to which recent large increases in hospitals’ adoption of electronic health record (EHR) systems can be attributed to the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 is uncertain and debated. The study aimed to assess how the HITECH Act influenced EHR adoption among eligible versus ineligible short‑term acute care hospitals before and after its implementation. The authors used national hospital data to compare annual EHR adoption rates between eligible and ineligible hospitals across the pre‑ (2008‑10) and post‑ (2011‑15) periods. Eligible hospitals saw annual EHR adoption rise from 3.2 % pre‑HITECH to 14.2 % post‑HITECH, whereas ineligible hospitals increased from 0.1 % to 3.3 %, yielding a 7.9‑percentage‑point difference‑in‑differences and supporting that HITECH drove the recent adoption gains.

Abstract

The extent to which recent large increases in hospitals' adoption of electronic health record (EHR) systems can be attributed to the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 is uncertain and debated. Because only short-term acute care hospitals were eligible for the act's meaningful-use incentive program, we used national hospital data to examine the differential effect of HITECH on EHR adoption among eligible and ineligible hospitals in the periods before (2008-10) and after (2011-15) implementation of the program. We found that annual increases in EHR adoption rates among eligible hospitals went from 3.2 percent in the pre period to 14.2 percent in the post period. Ineligible hospitals experienced much smaller annual increases of 0.1 percent in the pre period and 3.3 percent in the post period, a significant difference-in-differences of 7.9 percentage points. Our results support the argument that recent gains in EHR adoption can be attributed specifically to HITECH, which suggests that the act could serve as a model for ways to drive the adoption of other valuable technologies.