{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T02:28:41Z","timestamp":1773282521235,"version":"3.50.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2006,1,5]],"date-time":"2006-01-05T00:00:00Z","timestamp":1136419200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1472-6947-6-1","type":"journal-article","created":{"date-parts":[[2006,1,23]],"date-time":"2006-01-23T13:04:29Z","timestamp":1138021469000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":176,"title":["Assessing the level of healthcare information technology adoption in the United States: a snapshot"],"prefix":"10.1186","volume":"6","author":[{"given":"Eric G","family":"Poon","sequence":"first","affiliation":[]},{"given":"Ashish K","family":"Jha","sequence":"additional","affiliation":[]},{"given":"Melissa","family":"Christino","sequence":"additional","affiliation":[]},{"given":"Melissa M","family":"Honour","sequence":"additional","affiliation":[]},{"given":"Rushika","family":"Fernandopulle","sequence":"additional","affiliation":[]},{"given":"Blackford","family":"Middleton","sequence":"additional","affiliation":[]},{"given":"Joseph","family":"Newhouse","sequence":"additional","affiliation":[]},{"given":"Lucian","family":"Leape","sequence":"additional","affiliation":[]},{"given":"David W","family":"Bates","sequence":"additional","affiliation":[]},{"given":"David","family":"Blumenthal","sequence":"additional","affiliation":[]},{"given":"Rainu","family":"Kaushal","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2006,1,5]]},"reference":[{"key":"90_CR1","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"I Medicine","year":"2001","unstructured":"Medicine I: Crossing the Quality Chasm: A New Health System for the 21st Century. 2001, Washington, DC, National Academy Press"},{"key":"90_CR2","volume-title":"Medgenmed Medscape General Medicine","author":"G AA","year":"2000","unstructured":"AA G, DW B: The use of information technology in improving medical performance. Part II. Physician-support tools. Medgenmed Medscape General Medicine. 2000, E13:"},{"key":"90_CR3","volume-title":"The Use of Information Technology in Improving Medical Performance Part III.Patient-Support Tools","author":"AA Gawande","year":"2000","unstructured":"Gawande AA, Bates DW: The Use of Information Technology in Improving Medical Performance Part III.Patient-Support Tools. 2000"},{"key":"90_CR4","volume-title":"Online Patient-Provider Communication Tools: An overview","author":"FC Group","year":"2003","unstructured":"Group FC: Online Patient-Provider Communication Tools: An overview. 2003, California Healthcare Foundation"},{"key":"90_CR5","volume-title":"The Value of Healthcare Information Exchange and Interoperability","author":"P E","year":"2004","unstructured":"E P, D J, JD W, J AM, DW B, B M: The Value of Healthcare Information Exchange and Interoperability. 2004, Center for Information Technology Leadership, Boston, MA"},{"key":"90_CR6","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1001\/jama.280.15.1311","volume":"280","author":"DW Bates","year":"1998","unstructured":"Bates DW, Leape LL, Cullen DJ, Laird N, Petersen LA, Teich JM, Burdick E, Hickey M, Kleefield S, Shea B, Vander VM, Seger DL: Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998, 280: 1311-1316. 10.1001\/jama.280.15.1311.","journal-title":"JAMA"},{"key":"90_CR7","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/S0002-9343(03)00057-3","volume":"114","author":"W SJ","year":"2003","unstructured":"SJ W, B M, LA P, CG B, CD S, PJ C, AF K, RC G, DG F, AJ S, GJ K, DW B: A Cost-Benefit Analysis for Ambulatory-Care Electronic Medical Records in Primary Care. Am J Med. 2003, 114: 397-403. 10.1016\/S0002-9343(03)00057-3.","journal-title":"Am J Med"},{"key":"90_CR8","volume-title":"The Value of Computerized Provider Order Entry in Ambulatory Settings","author":"J D","year":"2003","unstructured":"D J, E P, J W, DW B, B M: The Value of Computerized Provider Order Entry in Ambulatory Settings. 2003, Center for Information Technology Leadership, HIMSS"},{"key":"90_CR9","volume-title":"Information for Health: A Strategy for Building the National Health Information Infrastructure","author":"National Committee on Vital Health Statistics","year":"2001","unstructured":"National Committee on Vital Health Statistics: Information for Health: A Strategy for Building the National Health Information Infrastructure. 2001, US Department of Health and Human Services"},{"key":"90_CR10","volume-title":"State of the Union Address.","author":"B GW.","year":"2004","unstructured":"GW. B: State of the Union Address. 2004"},{"key":"90_CR11","unstructured":"S.2003 SB: Health Information for Quality Improvement Act of 2003. 2004"},{"key":"90_CR12","volume-title":"Achieving Electronic Connectivity in Healthcare","author":"M Foundation","year":"2004","unstructured":"Foundation M, Foundation RWJ: Achieving Electronic Connectivity in Healthcare. 2004, [http:\/\/www.connectingforhealth.org]"},{"key":"90_CR13","volume-title":"Connecting Americans to Their Healthcare","author":"M Foundation","year":"2004","unstructured":"Foundation M, Foundation RWJ: Connecting Americans to Their Healthcare. 2004, [http:\/\/www.connectingforhealth.org]"},{"key":"90_CR14","volume-title":"The Decade of Health Information Technology: Framework for Strategic Action","author":"T TG","year":"2004","unstructured":"TG T, DJ B: The Decade of Health Information Technology: Framework for Strategic Action. 2004"},{"key":"90_CR15","first-page":"95","volume":"11","author":"A JS","year":"2004","unstructured":"JS A, PN G, V S, WR H: Computerized Physician Order Entry in US Hospitals: Results of a 2002 Survey. J of Am Med Inform Assoc. 2004, 11: 95-99.","journal-title":"J of Am Med Inform Assoc"},{"key":"90_CR16","first-page":"235","volume-title":"Proceedings AMIA Annual Symposium","author":"JS Ash","year":"1998","unstructured":"Ash JS, Gorman PN, Hersh WR: Physician order entry in U.S. hospitals. Proceedings AMIA Annual Symposium. 1998, 235-239."},{"key":"90_CR17","volume-title":"Computers in Clinical Practice","author":"MM Society","year":"2003","unstructured":"Society MM, University of Hong Kong Department of Community Medicine: Computers in Clinical Practice. 2003, [http:\/\/www.massmed.org\/pages\/120203pr_hongkong.asp]"},{"key":"90_CR18","volume-title":"Harris Interactive Health Care News","author":"H Interactive","year":"2002","unstructured":"Interactive H: European Physicians Especially in Sweden, Netherlands and Demark, Lead U.S. in Use of Electronic Medical Records. Harris Interactive Health Care News. 2002, 2:"},{"key":"90_CR19","doi-asserted-by":"publisher","first-page":"495","DOI":"10.7326\/0003-4819-129-6-199809150-00012","volume":"129","author":"KD Mandl","year":"1998","unstructured":"Mandl KD, Kohane IS, Brandt AM: Electronic patient-physician communication: problems and promise. [see comments.]. [Review] [60 refs]. Annals of Internal Medicine. 1998, 129: 495-500.","journal-title":"Annals of Internal Medicine"},{"key":"90_CR20","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1001\/archinte.163.12.1409","volume":"163","author":"K R","year":"2003","unstructured":"R K, KG S, DW B: Effects of Computerized Physician Order Entry and Clinical Decision Support Systems on Medication Safety: A Systematic Review. Arch Int Med. 2003, 163: 1409-1416. 10.1001\/archinte.163.12.1409.","journal-title":"Arch Int Med"},{"key":"90_CR21","volume-title":"Assessing the Information Technology Infrastructure in Integrated Delivery Systems","author":"S L","year":"2001","unstructured":"L S: Assessing the Information Technology Infrastructure in Integrated Delivery Systems. 2001, RTI International"},{"key":"90_CR22","volume-title":"Achieving Tangible IT Benefits in Small Physician Practices","author":"FC Group","year":"2002","unstructured":"Group FC: Achieving Tangible IT Benefits in Small Physician Practices. 2002, California Healthcare Foundation"},{"key":"90_CR23","first-page":"94","volume":"10","author":"D DF","year":"2003","unstructured":"DF D, DW B, BC J: The Use of Computers for Clinical Care: A Case Series of Advanced U.S. Sites. JAMIA. 2003, 10: 94-107.","journal-title":"JAMIA"},{"key":"90_CR24","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1377\/hlthaff.23.4.184","volume":"23","author":"P EG","year":"2004","unstructured":"EG P, Blumenthal D, T J, MM H, DW B, R K: Overcoming the Barriers to Implementing Computerized Physician Order Entry Systems in US Hospitals: Perspectives from Senior Management. Health Affairs. 2004, 23: 184-190. 10.1377\/hlthaff.23.4.184.","journal-title":"Health Affairs"},{"key":"90_CR25","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1377\/hlthaff.23.2.116","volume":"23","author":"M RH","year":"2004","unstructured":"RH M, Sim I: Physicians' Use of Electronic Medical Records: Barriers and Solutions. Health Aff (Millwood). 2004, 23: 116-126. 10.1377\/hlthaff.23.2.116.","journal-title":"Health Aff (Millwood)"},{"key":"90_CR26","volume-title":"American Community Survey Profile 2002","author":"USC Bureau","year":"2003","unstructured":"Bureau USC: American Community Survey Profile 2002. 2003, [http:\/\/www.census.gov\/acs\/www\/products\/profiles\/single\/2002\/acs\/index.htm]"},{"key":"90_CR27","unstructured":"Hospital Blue Book. 2003, Billian's HealthDATA Group"},{"key":"90_CR28","unstructured":"AAMC DataBook. 2004, Association of Americal Medical Colleges"},{"key":"90_CR29","volume-title":"Diffusion of innovations","author":"EM Rogers","year":"1983","unstructured":"Rogers EM: Diffusion of innovations. 1983, New York, The Free Press, 3rd","edition":"3rd"},{"key":"90_CR30","first-page":"22","volume":"2001","author":"A JS","year":"2001","unstructured":"JS A, J L, J C, L F: A Diffusion of Innovations Model of Physician Order Entry. Proceedings \/ AMIA Annual Symposium. 2001, 2001: 22-26.","journal-title":"Proceedings \/ AMIA Annual Symposium"},{"key":"90_CR31","volume-title":"The Diffusion of Process Innovations","author":"D S","year":"1979","unstructured":"S D: The Diffusion of Process Innovations. 1979, Cambridge University Press"},{"key":"90_CR32","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1001\/jama.1995.03530010099050","volume":"274","author":"T Bodenheimer","year":"1995","unstructured":"Bodenheimer T, Grumbach K: A Clinical Approach: The Reconfiguration of US Medicine. JAMA. 1995, 274: 85-90. 10.1001\/jama.274.1.85.","journal-title":"JAMA"},{"key":"90_CR33","first-page":"42","volume":"17","author":"G JP","year":"2003","unstructured":"JP G, G DB, L S: The New England Healthcare EDI Network. J Healthc Inf Manag. 2003, 17: 42-50.","journal-title":"J Healthc Inf Manag"},{"key":"90_CR34","volume-title":"Chartbook on Trends in the Healthof Americans","author":"P PN","year":"2002","unstructured":"PN P, DM M, C R, H X: Chartbook on Trends in the Healthof Americans. 2002, National Center for Health Statistics"},{"key":"90_CR35","first-page":"406","volume":"250","author":"E AM","year":"2004","unstructured":"AM E, TH L, MB H: Paying physicians for high-quality care. New Engl J Med. 2004, 250: 406-410.","journal-title":"New Engl J Med"},{"key":"90_CR36","volume-title":"Medinfo 2004 Conference, San Francisco, CA, 2004 Sept","author":"KAFLMVLAGSWSJBDW Pizziferri L","year":"2004","unstructured":"Pizziferri L KAFLMVLAGSWSJBDW: Does Using an Electronic Health Record Require More Time for Primary Care Physicians?. Medinfo 2004 Conference, San Francisco, CA, 2004 Sept. 2004"},{"key":"90_CR37","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1136\/jamia.2001.0080361","volume":"8","author":"JM Overhage","year":"2001","unstructured":"Overhage JM, Perkins S, Tierney WM, McDonald CJ: Controlled Trial of Direct Physician Order Entry: Effects on Physicians' Time Utilization in Ambulatory Primary Care Internal Medicine Practices. J Am Med Inform Assoc. 2001, 8: 361-371.","journal-title":"J Am Med Inform Assoc"},{"key":"90_CR38","volume-title":"Primary Care Informatics Interest Group Annual Retreat, AMIA 2003","author":"B M","year":"2003","unstructured":"M B: Primary Care Informatics Interest Group Annual Retreat, AMIA 2003. 2003"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-6-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1472-6947-6-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-6-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1472-6947-6-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T22:34:13Z","timestamp":1630449253000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedinformdecismak.biomedcentral.com\/articles\/10.1186\/1472-6947-6-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1,5]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,12]]}},"alternative-id":["90"],"URL":"https:\/\/doi.org\/10.1186\/1472-6947-6-1","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1,5]]},"assertion":[{"value":"24 September 2005","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2006","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2006","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"1"}}