American hospitals have fewer fully functional electronic health records systems than previously believed. Less than 2 percent of the 2,952 hospitals surveyed by researchers at Harvard University have installed EHR systems in all clinical departments.

Of the respondents, 7.6 percent reported having a basic EHR system in at least one department. Larger urban hospitals and teaching institutions were the most likely to have adopted EHRs, according to the study, which was published in the March 25 New England Journal of Medicine. Previous estimates of EHR adoption in hospitals ranged from 5 percent to 59 percent.

The survey's results make the federal government's goal of a full, national EHR implementation by 2014 seem like a steep challenge. "We have a long way to go," says Ashish K. Jha, MD, MPH, the study's lead author, in a news report. "Even if a hospital does have electronic health records, it does not mean that it is sharing information with other hospitals and doctors down the road."

According to the study, hospitals say the biggest barriers to EHR adoption are their initial costs and their anticipated continuing maintenance costs.

One of the study's co-authors, David Blumenthal, MD, MPH, was named national coordinator for health information technology by the Obama administration, which has allotted $19 billion to encourage EHR adoption.

Kent Steinriede

The U.S. Department of Veterans Affairs has warned thousands of veterans that they may have been exposed to infectious diseases after being treated at VA clinics with improperly disinfected endoscopy equipment.

The agency is currently evaluating the results of a nationwide procedure and training review of all VA medical centers and outpatient clinics, according to a VA spokeswoman. The review was conducted in response to reports in February of "improperly reprocessed" equipment used during colonoscopies at a VA hospital in Murfreesboro, Tenn., as well as in ENT exams at a VA clinic in Augusta, Ga. The agency mailed letters to thousands of veterans who were treated at those facilities as far back as April 2003, warning them about the improperly sterilized equipment and their potential exposure to HIV and hepatitis.

The recent review yielded a similar discovery at a Miami VA hospital. More than 3,000 patients who had undergone colonoscopies there were informed last week that the water tubes and reservoirs used in the procedures had been rinsed but not disinfected between cases, as per manufacturers' guidelines. The VA is encouraging the patients to be tested for HIV, hepatitis and other infectious diseases as it continues to determine whether other facilities neglected proper cleaning and sterilizing practices, which it attributes to human error.

Meanwhile, U.S. Sen. Bill Nelson (D-Fla.) and U.S. Rep. Kendrick Meek (D-Fla.) have sent a formal letter to VA Secretary Eric Shinseki, calling for a broader inquiry by the VA Office of Inspector General to determine what went wrong and "how we can prevent such problems from happening again."

Irene Tsikitas

The non-toxic glue that mussels create in order to stick to rocks or the hulls of boats may someday be used as a biodegradable spray-on suture.

Researchers have created an applicator using the technology behind inkjet printers that allows them to spray the mussels' soluble protein adhesive and bind wet surfaces.

This adhesive could be used for wound closure in the operating room, including for eye surgery or fracture fixation, says Roger Narayan, PhD, MD, co-author of an article on the technique to be published in April's Journal of Biomedical Materials Research: Part B.

Unlike current synthetic tissue glues, mussels' glue is non-toxic, biodegradable and made from a renewable resource. Because it sticks to stone, wood, metal and even Teflon, it has been widely studied. So far it has been difficult to recreate. But coupling the glue with an effective application process may help to develop a product.

"Inkjet technology gives you greater control over the placement of the adhesive," said Dr. Narayan, an assistant professor in biomedical engineering at North Carolina State University and the University of North Carolina, in a press release. "This helps ensure that the tissues are joined together in just the right spot, forming a better bond that leads to improved healing and less scarring."

Kent Steinriede

Despite strong evidence in favor of double-gloving, only 28 percent of the 36 readers who answered last week's Instapoll say the practice is common in their ORs. Double-gloving can significantly decrease risk in certain procedures, especially invasive procedures, and industry surveys show glove failure rates vary from 11 percent to 51 percent.

This week's poll asks if your ORs have gone green yet. Go to our front page to participate in the poll and view real-time results.

Dan O'Connor