Integration of prescription drug monitoring program (PDMP) databases with electronic health records (EHRs) is an important tool in combating the opioid crisis in the US. We assessed nationwide hospital adoption of three EHR capabilities related to opioid prescribing and PDMP integration: ability to electronically prescribe controlled substances, checking of state PDMPs directly from EHRs, and integration of PDMP data into EHRs. Less than one third of hospitals reported the ability to check state PDMPs, and only 14% reported full PDMP data integration. More troublingly, hospitals in high opioid-prescribing counties were less likely to report these capabilities.
Responding to the COVID-19 pandemic requires effective public health informatics infrastructure, which includes electronic reporting of cases and other data from hospitals to public health agencies. We analyzed 2018 hospital data to assess barriers to public health reporting, and found that 41% of hospitals indicated public health agencies’ inability to receive data as a barrier. These challenges reflect systematic under-investment in public health informatics, and federal health information technology programs largely focused on provider organizations like hospitals, rather than public health agencies.
The regulatory environment surrounding health information exchange (HIE) is complex, and includes variations in state policies regarding patient consent for data exchange. We analyzed 2016 national hospital data and found that hospitals in states with opt-in consent policies were more likely to report regulatory barriers to health information exchange, compared to hospitals in opt-out consent states. However, this was concentrated among less technologically equipped hospitals. We found no relationship between consent policies and the actual amount of HIE in which a hospital engaged, suggesting that burdens brought on by opt-in policies may fall disproportionately on less technologically advanced hospitals. This may further exacerbate the digital divide in hospital technology adoption.