Health information technology (HIT) is a broad term that encompasses various types of health informatics tools, including the use of (1) electronic medical records (EMRs) or electronic health records (EHRs) in health provider settings, (2) personal health records (PHRs) primarily used by consumers, (3) telemedicine across organizations and geographic settings, as well as other types of electronic/mobile health devices. For this chapter, the author focuses on EMRs and EHRs for answering this question, just to provide clarity in answering why the EMR adoption rate varies across the health industry. Later chapters

(such as Chapters 8 and 9) will provide greater clarity on the second and third objectives. The term EMR is used when referring to an intraorganization health information system, and EHR when referring to the interorganization health system. A recent Robert Wood Johnson Foundation (RWJF, 2013) reports trends in EHR adoption between 2006 and 2013 in the rate of technology adoption across the U.S. healthcare industry. For example, they suggest that about 80% of large, capital-rich organizations have adopted (certified or uncertified) EHRs, compared to about 40% of small, capital-poor organizations. Differences in EHR adoption persist across geographic areas, urban or rural settings, and the ownership status of the organization or practice (RWJF, 2013). Looking at this data, it is important to analyze the rate of adoption within the U.S. health industry to see what causes the differences in health information technology adoption, including economic, social, and environmental factors that may be slowing the rate of adoption for specific health providers.