Original Paper

Journal of Medical Systems

, Volume 30, Issue 6, pp 429-438

First online:

Clinical Information System Availability and Use in Urban and Rural Hospitals

  • Marcia M. WardAffiliated withDepartment of Health Management and Policy, University of IowaCenter for Research in the Implementation of Innovative Strategies in Practice, Iowa City VA Medical Center Email author 
  • , Mirou JaanaAffiliated withDepartment of Health Management and Policy, American University of Beirut
  • , James A. BahenskyAffiliated withDepartment of Health Management and Policy, University of Iowa
  • , Smruti VartakAffiliated withDepartment of Health Management and Policy, University of Iowa
  • , Douglas S. WakefieldAffiliated withDepartment of Health Management and Informatics, Center for Health Care Quality, University of Missouri

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Clinical information systems (CIS) capture clinical data to support more efficient and effective decision making and clinical care delivery. Only a few estimates of CIS availability and use in hospitals are available nationally. The purpose of the current research is to examine differences in CIS availability and use between urban and rural hospitals. A survey addressing this purpose was completed by 74 (63.7%) of Iowa hospitals. Rural hospitals lag behind urban hospitals in terms of many CIS applications. More than 80% of the urban hospitals, but only between 30 and 40% of the rural hospitals, reported using computers to collect basic clinical information for potential use in an electronic medical record (EMR) and computerized provider order entry (CPOE) system. Comparison of CIS within one state’s urban and rural hospitals sheds light on variation in clinical support applications, decision support, and electronic medical record “readiness” in these settings.


Hospital information systems Decision support systems Clinical hospitals Rural medical records systems Computerized medical informatics