AEM: Urban EDs 14x more likely to adopt CPOE
Health IT adoption varies by state and urbanicity, with less computerized provider order entry (CPOE) in rural emergency departments (EDs), according to research published in the August edition of Annals of Emergency Medicine.
“Urban emergency departments were substantially more likely (14 times greater odds) to have adopted computerized provider order entry (systems) than rural emergency departments,” the authors continued.
Daniel J. Pallin, MD, MPH, from the department of emergency medicine at Brigham and Women’s Hospital in Boston, and colleagues sought to assess the prevalence of emergency department CPOE in four states, identify characteristics predicting CPOE adoption and assess adoption in one state over time, all before incentive programs.
The researchers surveyed all nonfederal EDs in Massachusetts, Colorado, Georgia and Oregon, assessing health IT prevalence in 2008, focusing on CPOE. They used multivariable logistic regression to evaluate predictors of adoption, and compared the Massachusetts data with data from a similar survey conducted for Massachusetts in 2005, using 95 percent confidence intervals to assess the change in rate.
The authors identified and surveyed 351 EDs, and 83 percent responded to the CPOE module. Of these, 30 percent had adopted CPOE, the authors found. Odds of CPOE in rural EDs were 0.07 relative to urban.
In addition, Oregon EDs had a higher likelihood of CPOE entry adoption than Georgia EDs, the state with the lowest adoption. In 2005, 15 percent of Massachusetts EDs reported CPOE versus 44 percent in 2008 (29 percent difference).
Emergency department adoption of CPOE nearly tripled in Massachusetts from 2005 to 2008, before any financial incentives. Though the authors noted a significant increase in Massachusetts, they reiterated that only 30 percent of the EDs studied had adopted CPOE by 2008.
“Federal resources might be more effective if they helped providers select health IT tools, improve health IT design and evaluate its influence on care delivery, versus simply calling for ‘more,’” the authors concluded.
“Urban emergency departments were substantially more likely (14 times greater odds) to have adopted computerized provider order entry (systems) than rural emergency departments,” the authors continued.
Daniel J. Pallin, MD, MPH, from the department of emergency medicine at Brigham and Women’s Hospital in Boston, and colleagues sought to assess the prevalence of emergency department CPOE in four states, identify characteristics predicting CPOE adoption and assess adoption in one state over time, all before incentive programs.
The researchers surveyed all nonfederal EDs in Massachusetts, Colorado, Georgia and Oregon, assessing health IT prevalence in 2008, focusing on CPOE. They used multivariable logistic regression to evaluate predictors of adoption, and compared the Massachusetts data with data from a similar survey conducted for Massachusetts in 2005, using 95 percent confidence intervals to assess the change in rate.
The authors identified and surveyed 351 EDs, and 83 percent responded to the CPOE module. Of these, 30 percent had adopted CPOE, the authors found. Odds of CPOE in rural EDs were 0.07 relative to urban.
In addition, Oregon EDs had a higher likelihood of CPOE entry adoption than Georgia EDs, the state with the lowest adoption. In 2005, 15 percent of Massachusetts EDs reported CPOE versus 44 percent in 2008 (29 percent difference).
Emergency department adoption of CPOE nearly tripled in Massachusetts from 2005 to 2008, before any financial incentives. Though the authors noted a significant increase in Massachusetts, they reiterated that only 30 percent of the EDs studied had adopted CPOE by 2008.
“Federal resources might be more effective if they helped providers select health IT tools, improve health IT design and evaluate its influence on care delivery, versus simply calling for ‘more,’” the authors concluded.