Hospitals increasingly are using electronic health records to improve health care. But smaller, rural or nonteaching hospitals are trailing the big boys, and the gap is growing larger, according to a recent study published in Health Affairs and co-authored by the American Hospital Association.

The AHA analyzed national survey data on U.S. hospitals from 2011, when federal incentives started to kick in for the meaningful use of electronic health records. They found that the number of providers using EHR systems increased from 15.1 percent in 2010 to 26.6 percent last year.

In addition, the number of hospitals using "comprehensive" data systems — containing patient demographics, care histories, lab results, etc. — rose from 3.6 to 8.7 percent, year to year. However, hospitals in rural areas had the lowest rate of adoption out of any group analyzed, according to the AHA, with just 19.4 percent having basic EHR systems in 2011.

Here are some other findings:

  • The number of hospitals using EHR data in a meaningful manner increased, with some 18.4 percent of providers having these functions in place in one unit, and 11.2 percent in all clinical units.
  • As of February, more than 800 of the country's 5,000 hospitals had received a total of $1.4 billion in Medicare incentive payments, and more than 3,000 registered for the Medicare or Medicaid EHR incentive program.
  • The gap of EHR adoption between large and small, rural or nonteaching hospitals increased "substantially" in recent years, from 15 percentage points in 2010 to 22.2 percentage points last year. More specifically, 25.7 percent of larger hospitals adopted EHR systems in 2010 versus 10.7 percent of their smaller counterparts. That number jumped to 43 percent of larger providers versus 20.8 percent of small, rural or nonteaching last year.