Adoption of Information Technology in Massachusetts Emergency Departments

Background: Information technology improves outcomes (e.g., by reducing error), and universal implementation of electronic medical records throughout the United States is a national goal. Prior studies have shown low rates of implementation. Objectives: To assess the current state of acquisition and implementation of information technology tools in Massachusetts emergency departments (EDs). Methods: This was part of a larger survey that sought to describe various attributes of all non-federal Massachusetts EDs. We asked about implementation of technologies listed below, and report proportions (95% confidence intervals) and medians (interquartile ranges). We compare responding to non-responding EDs to guard against response bias. Results: We identified and surveyed 74 non-federal EDs; 61 (82%) responded. Of these, the following number (%) reported full implementation of the following technologies: medication ordering, 9 (15%); medication error checking, 7 (11%); current visit information (e.g., chief complaint), 25 (41%); computerized management recommendations based on clinical decision rules, 6 (10%); electronic laboratory results, 55 (90%); computerized clinical reminders, 10 (17%); tracking information, 31 (51%); hospital discharge summaries, 50 (82%); current outpatient medications, 15 (25%); ED visit notes, 30 (49%); radiographic images from a prior visit, 39 (64%); old electrocardiograms, 33 (54%); and computer system to collect real-time clinical data, 23 (38%). Conclusion: Massachusetts EDs have been slow to adopt evidence-based information technologies. A collaborative approach to determining the best available technologies and their implementation would decrease duplication of effort, frustration, and financial waste (due to non-implementation of acquired systems), and would facilitate inter-operability of ED computer systems.