The Medicare Electronic Health Records (EHR) Incentive Program: First-Year Adoption Response from Inpatient Hospitals

This study investigates electronic health records (EHR) adoption among inpatient hospitals in response to the first operational year of the Medicare EHR Incentive Program. Profile analysis of public attestation datasets finds both system adoption rates and implemented functionalities to have been significantly influenced by the incentive program's attributes. Key dates and periods in the program's well-publicized timeline were usually accompanied by spikes in the number of attested systems and/or dips in advanced functionalities. The implication is that hospitals have responded to the program by swiftly implementing EHR systems with capabilities just sufficient to meet program requirements, in order to be able to promptly file attestations and thus claim their incentive payments. The program therefore appears to have yielded mixed results. While it seems to have induced more hospitals to acquire EHR systems, the implemented systems generally possess minimal functionalities, suggesting that adopters have leveraged the program's rules in order to maximize their own short-term gains.