Some providers, such as the VHA, have successfully
implemented electronic-records systems. VHA
hospitals have used electronic health records for
more than a decade with dramatic associated improvements
in clinical quality.22,23 Their medical
records are nearly wholly electronic, and including
them in our analyses led to a doubling of our
count of U.S. hospitals with a comprehensive system.
Some developed countries, such as the United
Kingdom and the Netherlands, have also successfully
spurred adoption of health information technology, although most of their progress has been
in ambulatory care. Few countries have yet to make
substantial progress in the inpatient setting.