Regional differences in electronic medical record adoption in Japan: A nationwide longitudinal ecological study

International Journal of Medical Informatics
Hideaki KawaguchiKazuhiko Ohe

Abstract

Regional differences in the adoption of electronic medical records (EMR) are a major problem, yet little is known about these differences internationally. We analyzed regional differences in EMR adoption in Japan and evaluated factors associated with these differences. This nationwide ecological study used secondary data from all secondary medical service areas (SMSAs) in fiscal years 2008 (n = 348) and 2014 (n = 344). For each SMSA we collected the following information from a Japanese national database: the number of medical facilities that had adopted EMR, the population density, the average per capita income, the number of working doctors per 1000 people, and the proportion of interns to all working doctors. To adjust for medical facility characteristics in each SMSA, such as number of beds, public versus private hospital, and hospital type (psychiatric or other), we estimated the standardized adoption ratio (SAR) for EMR adoption, modeled on the standardized mortality ratio. We calculated Moran's I for the SAR and investigated whether the SAR had spatial autocorrelations. We evaluated the association between the SAR and regional factors with a conditional autoregressive model. We compared these results in 2008 and 2014, fo...Continue Reading

Citations

Jul 14, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Ryo MatsuokaIssei Komuro
Aug 4, 2020·Journal of Medical Systems·Placide Poba-NzaouShinji Kobayashi

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