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The Adoption and Use of Health Information Technology in Rural Areas: Results of a National Survey

Authors

  • Ranjit Singh MBBChir, MA (Cantab.), MBA,

    1. Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York
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  • Michael I. Lichter PhD,

    1. Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York
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  • Andrew Danzo BA,

    1. Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York
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  • John Taylor MBA,

    1. Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York
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  • Thomas Rosenthal MD

    1. Primary Care Research Institute, Department of Family Medicine, University at Buffalo, State University of New York, Buffalo, New York
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  • This study was supported by a grant from the United States Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, grant number R04RH08597. Principal Investigator: Ranjit Singh. For further information, contact: Ranjit Singh, MBBChir, MA (Cantab.), MBA, Primary Care Research Institute, Department of Family Medicine, UB Clinical Center, 462 Grider St. Buffalo, NY 14215-3021; e-mail rs10@buffalo.edu.

Abstract

Context: Health information technology (HIT) is a national policy priority. Knowledge about the special needs, if any, of rural health care providers should be taken into account as policy is put into action. Little is known, however, about rural-urban differences in HIT adoption at the national level.

Purpose: To conduct the first national assessment of HIT in rural primary care offices, with particular attention to electronic medical record (EMR) adoption, range of capabilities in use, and plans for adoption.

Methods: A national mail survey of 5,200 primary care offices, stratified by rurality using Rural-Urban Commuting Area categories, was conducted in 2007-2008. Regression analyses were used to assess the relationship between office characteristics and EMR adoption, capabilities used, and future adoption plans.

Results: A commercial EMR system was present in 31% of offices, with no significant differences by rurality. Of offices with EMRs, 12% reported using a full range of EMR capabilities, with 51% using a basic range and 37% using less than the basic range. Large Rural (adjusted OR = 3.71, P= .022) and Small Rural (aOR = 3.75, P= .049) offices were more likely than Urban offices to use a broader range of EMR capabilities. Among offices without EMRs, those in Isolated areas were less likely to have more immediate plans to adopt (aOR = 0.19, P= .02).

Conclusions: HIT adoption and use in rural primary care offices does not appear to be lower than in urban offices. The situation, however, is dynamic and warrants further monitoring.

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