The Mongan Institute for Health Policy serves as the research team for the National Coordinator for Health Information Technology (HIT) in the US Department of Health and Human Services. HIT has the potential to advance health care quality through, among other things, improving compliance with recommended care for patients with acute and chronic conditions, reducing disparities in treatment, and reducing medical errors. However, studies of HIT adoption suggest multiple barriers, ranging from physicians’ reluctance to adopt new information technologies to the cost of HIT in upfront capital investment, maintenance, and short-term loss of productivity.
The Center’s work on HIT adoption has focused on constructing an information base that includes data on rates and patterns of electronic health record (EHR) adoption, areas and reasons for success and failure in adoption and use, variations by provider type and geography, and policy-relevant findings on how to facilitate dissemination and effective implementation. Moreover, the Mongan Institute for Health Policy, in conjunction with the Office of the National Coordinator, is conducting a national survey of community health centers (CHCs), to determine the scale of and obstacles to the adoption of HIT. This information base serves as a departure point for critically analyzing emerging disparities in HIT adoption (especially with respect to minority-serving hospitals), and provides insight into the unique problems likely to affect safety net institutions and vulnerable populations with respect to access to EHRs.
- Jha A., Ferris T.G., Donelan K, DesRoches C, Shields A.E., Rosenbaum, S, Blumenthal, D. How common are electronic health records in the United States? A summary of the evidence. Health Affairs. 2006; 25(6):w496-w507.
- Shields A.E. Will Differential HIT Adoption Exacerbate Health Disparities? In: Blumenthal, D., DesRoches, C., Donelan, K., et al, eds. Health Information Technology in the United States: The Information Base for Progress. Princeton, NJ: Robert Wood Johnson Foundation; 2006:29-41.
- Shields A.E., Shin P., Leu M., Levy D.E., Betancourt, R.M., Hawkins, D. and Proser, M. Adoption of Health Information Technology in Community Health Centers: Results of a national survey. Health Affairs. 2007; 26(5):1373-1383. PMID: 17848448.
- DesRoches C., Campbell E.G., Rao S., Jha A.K., Donelan K., Ferris T., Levy D.E., Kaushal R., Rosenbaum S., Shields A.E., Blumenthal D. Electronic health records in ambulatory care – a national survey of physicians. New England Journal of Medicine. 2008; Jul; 359(1): 50-60. PMID: 18565855.
- Shields A.E., Rao S.R., Kwong R.M. Are Physicians Serving Poor and Minority Patients Keeping Pace With EHR Adoption? In: Blumenthal D., DesRoches C., Foubister V, eds. Health Information Technology in the United States: Where We Stand 2008. Princeton, NJ: Robert Wood Johnson Foundation; 2008:25-55.
- Jha A.K., DesRoches C.M., Campbell E.G., Donelan K., Rao S.R., Ferris T.G., Shields A.E., Rosenbaum S., Blumenthal D. Use of Electronic Health Records in U.S. Hospitals. The New England Journal of Medicine. 2009; Apr 16; 360(16): 1628-38.
- Jha A.K., DesRoches C.M., Shields A.E., Miralles P.D., Zheng J., Rosenbaum S., Campbell E.G. Evidence of an emerging digital divide among hospitals that care for the poor. Health Affairs. 2009; Nov-Dec; 28(6): w1160-70. PMID: 19858142.
- DesRoches C.M., Campbell E.G., Vogeli C., Zheng J., Rao S.R., Shields A.E., Donelan K., Rosenbaum S., Bristol S.J., Jha A.K. Electronic Health Records' Limited Successes Suggest More Targeted Uses. Health Affairs. April 2010; 29(4)L 639-46. PMID: 20368593.