The rate of U.S. hospitals with at least a basic EHR has increased from 59 percent in 2013 to 75 percent this year, according to a study published in Health Affairs.

Among the 25 percent of hospitals that had not yet adopted at least a basic EHR system, the majority were close, according to the authors, led by Julia Adler-Milstein, PhD, assistant professor in the School of Information and in the Department of Health Management and Policy, School of Public Health, University of Michigan. The median number of basic EHR functions adopted was nine of 10, and 75 percent of this group had eight or more basic EHR functions in place. Physician notes was the EHR function that was most often missing (for 61 percent of hospitals without at least a basic EHR), followed by ability to view diagnostic test results (38 percent) and discharge summaries (26 percent).

Unsurprisingly, those facilities without that basic functionality tend to be small and rural, the researchers point out. "While EHR adoption has increased steadily since 2010," according to the study, "it's unclear how providers that haven't yet adopted will fare now that federal incentives have converted to penalties."

"Our findings suggest nationwide hospital EHR adoption is in reach but will require attention to small and rural hospitals and strategies to address financial challenges, particularly now that penalties for lack of adoption have begun," the authors concluded.

Read the full report.