Systems analysis of electronic health record adoption in the U.S. healthcare system

The U.S. has the largest and the most costly healthcare system in the world. Quality and cost of healthcare services are affecting peoples' lives, the country's population health, and the economy. In searching for ways to improve delivery of healthcare services, better integration and effective utilization of Health Information Technology (HIT) with an emphasis on Electronic Health Records (EHRs) is one of the propositions that the healthcare industry has a near consensus on. However, EHR adoption in the U.S. healthcare system moves slowly.;The major area of this research is the analysis of the EHR adoption process in the U.S. healthcare system from a systems perspective. The main objective is to provide ways of understanding the adoption process and to develop tools for use in evaluating improvement opportunities. In this attempt, this study uses a System Dynamics (SD) methodology. A systems analysis through the development of a causal loop model is performed to identify the main factors of the adoption process and to uncover the dynamics of the system. Then, an SD simulation model is developed that provide grounds for evaluation of interventions that might accelerate the adoption rate. This model allows an understanding of the operation of the process under the current system structure and is used as a test-bed for predicting (1) which policies/factors affect the EHR adoption, (2) what type of interventions can accelerate the adoption, (3) how these interventions can be integrated into the system, and (4) with these interventions, what the outlook will be on the adoption process.