The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023
Summary. Rural hospitals lag behind urban hospitals in adopting advanced electronic health record capabilities, despite widespread basic EHR adoption. From 2008 to 2023, rural hospitals remained 4–15% behind urban peers in interoperability, public health reporting, and social determinants of health data collection. These persistent gaps limit rural hospitals' ability to share data, conduct public health reporting, and drive data-informed care improvements, requiring targeted support for advanced EHR functions.
Cite this article
Anzalone, A., Liu, Y., Reisher, E., Frankel, E., Hansen, J. R., & Geary, C.. (2026). The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023. Journal of the American Medical Informatics Association. https://doi.org/10.1093/jamia/ocag043
Anzalone, Alfred, et al. “The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023.” Journal of the American Medical Informatics Association, 2026. https://doi.org/10.1093/jamia/ocag043.
Anzalone, Alfred, Y. Liu, Elizabeth Reisher, Emily Frankel, Jed R Hansen, and Carol Geary. 2026. “The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023.” Journal of the American Medical Informatics Association. https://doi.org/10.1093/jamia/ocag043.
@article{anzalone-2026-digital-divide-adoption-advanced-use,
title = {The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023},
author = {Alfred Anzalone and Y. Liu and Elizabeth Reisher and Emily Frankel and Jed R Hansen and Carol Geary},
journal = {Journal of the American Medical Informatics Association},
year = {2026},
doi = {10.1093/jamia/ocag043},
url = {https://doi.org/10.1093/jamia/ocag043}
}
TY - JOUR TI - The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023 AU - Alfred Anzalone AU - Y. Liu AU - Elizabeth Reisher AU - Emily Frankel AU - Jed R Hansen AU - Carol Geary JO - Journal of the American Medical Informatics Association PY - 2026 DO - 10.1093/jamia/ocag043 UR - https://doi.org/10.1093/jamia/ocag043 ER -
Details
- DOI
- 10.1093/jamia/ocag043
- Countries
- United States
- Regions
- North America
- Categories
- rural-healthcare, broadband-and-digital, general-innovation
- Added
- 2026-08-01