Comparing the Trends of Electronic Health Record Adoption Among Hospitals of the United States and Japan

J Med Syst. 2019 Jun 11;43(7):224. doi: 10.1007/s10916-019-1361-y.


The goal of this study is to examine the trends of Electronic Health Record (EHR) adoption among hospitals in Japan compared to those in the United States. Japan's nationwide survey of hospitals was utilized to extract the EHR adoption rates among Japanese hospitals. Comparable datasets from the Healthcare Information and Management System Society (HIMSS) and the American Hospital Association (AHA) were utilized to extract EHR adoption rates among U.S. hospitals. The trends of EHR adoption were stratified and analyzed by hospital size and hospital ownership status. As of 2014, the U.S. hospitals had a wider adoption of 'basic with clinical notes' EHRs compared to Japan (45.6% vs. 27.3%), but large hospitals (400+ beds) in Japan have shown a similar adoption rate of EHR systems than those of U.S. (65.6% vs. 68.5%). Governmental hospitals tend to be more advanced in EHR adoption than non-profit hospitals in Japan (53.0% vs. 21.5%). Non-profit hospitals show the highest adoption rate of 'basic' EHR systems in the U.S. as of 2014 (63.3%). Using the 'certified' definition of EHRs, the EHR adoption rate was close to 96% among U.S. hospitals as of 2016; however, updated EHR adoption data from Japanese hospitals has yet to be collected and published. U.S. and Japan have considerably increased EHR adoption among hospitals; however, this analysis indicates different trends of EHR adoption among hospitals by size and ownership status in both countries. Learnings from government programs supporting EHR adoption in the U.S. and Japan can be helpful in planning useful strategies for future hospital-oriented health IT policies in other developed nations.

Keywords: EHR adoption rate; Electronic health records (EHR); Hospitals; Japan; United States.

MeSH terms

  • Diffusion of Innovation*
  • Electronic Health Records*
  • Hospital Bed Capacity
  • Hospitals*
  • Japan
  • Ownership
  • United States