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More than 75% of U.S. hospitals had adopted at least a basic electronic health record system by the end of 2014, up from 59% in 2013, according to a study reported  today by Health Affairs. About 40% of hospitals were able to meet all 16 core objectives for Stage 2 meaningful use, up from just 6% in 2013. “However, our data reveal specific domains in which hospitals are struggling – with implementing physician notes, with physician resistance, with complexity of meeting meaningful-use criteria, and with controlling both upfront and ongoing costs associated with EHR adoption,” the report states. “Policy strategies that target these issues will disproportionately benefit small and rural hospitals, which continue to lag behind” their better resourced counterparts. Hospitals must meet meaningful use every year to avoid significant payment penalties under Medicare and losing promised incentives. Staff from the Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology and AHA participated in the study, which is based on AHA survey data.