Rural emergency departments were much less likely than those of urban hospitals to have computerized physician order entry systems, according to a study of EDs in four states that used 2008 data. But technological advances may have helped reduce the disparity since then, one health IT consultant said. While CPOE was installed in 6% of rural EDs and 21% of EDs in rural areas close to cities, it was available in 40% of urban EDs. On average, 30% of the 290 responding non-federal EDs in Colorado, Georgia, Massachusetts, and Oregon had CPOE systems, said the study in the Annals of Emergency Medicine . Of the four states, Massachusetts had the highest CPOE penetration in its EDs: 44%, compared to just 15% in 2005. (Massachusetts was the only state in which the researchers surveyed EDs in both years.) In Oregon, 34% of the EDs had CPOE in 2008; in Colorado the rate was 25%, and 24% in Georgia. Doug Hires, a partner in health IT advisory firm Santa Rosa Consulting, noted that rural and critical access hospitals have long been behind in IT. Part of that has to do with a lower level of resources compared to their urban counterparts, which tend to be larger organizations.