The Effect of Electronic Medical Record Adoption on Outcomes in US Hospitals

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2013 Feb 5

PMID 23375071

Citations 33

Authors

Jinhyung Lee

Yong-Fang Kuo

James S Goodwin

Affiliations

Soon will be listed here.

Abstract

Background: The electronic medical record (EMR) is one of the most promising components of health information technology. However, the overall impact of EMR adoption on outcomes at US hospitals remains unknown. This study examined the relationship between basic EMR adoption and 30-day rehospitalization, 30-day mortality, inpatient mortality and length of stay.

Methods: Our overall approach was to compare outcomes for the two years before and two years after the year of EMR adoption, at 708 acute-care hospitals in the US from 2000 to 2007. We looked at the effect of EMR on outcomes using two methods. First, we compared the outcomes by quarter for the period before and after EMR adoption among hospitals that adopted EMR. Second, we compared hospitals that adopted EMR to those that did not, before and after EMR adoption, using a generalized linear model.

Results: Hospitals adopting EMR experienced 0.11 (95% CI: -0.218 to -0.002) days' shorter length of stay and 0.182 percent lower 30-day mortality, but a 0.19 (95% CI: 0.0006 to 0.0033) percent increase in 30-day rehospitalization in the two years after EMR adoption. The association of EMR adoption with outcomes also varied by type of admission (medical vs. surgical).

Conclusions: Previous studies using observational data from large samples of hospitals have produced conflicting results. However, using different methods, we found a small but statistically significant association of EMR adoption with outcomes of hospitalization.

Citing Articles

Barriers and facilitators of the electronic medical record adoption among healthcare providers in Addis Ababa, Ethiopia.

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Strategy for scheduled downtime of hospital information system utilizing third-party applications.

Jo I, Kim W, Lim Y, Kang E, Kim J, Chung H BMC Med Inform Decis Mak. 2024; 24(1):300.

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An Assessment of Success Factors and Challenges in Implementation of Electronic Medical Record System in Referral Hospital in Northern Tanzania.

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Snowdon A, Hussein A, Danforth M, Wright A, Oakes R J Med Internet Res. 2024; 26:e56316.

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Bogale T, Derseh L, Abraham L, Willems H, Metzger J, Abere B Front Digit Health. 2024; 6:1377826.

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References

Silow-Carroll S, Edwards J, Rodin D . Using electronic health records to improve quality and efficiency: the experiences of leading hospitals. Issue Brief (Commonw Fund). 2012; 17:1-40. View

Parente S, Van Horn R . Valuing hospital investment in information technology: does governance make a difference?. Health Care Financ Rev. 2007; 28(2):31-43. PMC: 4194982. View

McCullough J, Casey M, Moscovice I, Prasad S . The effect of health information technology on quality in U.S. hospitals. Health Aff (Millwood). 2010; 29(4):647-54. DOI: 10.1377/hlthaff.2010.0155. View

Yu F, Menachemi N, Berner E, Allison J, Weissman N, Houston T . Full implementation of computerized physician order entry and medication-related quality outcomes: a study of 3364 hospitals. Am J Med Qual. 2009; 24(4):278-86. PMC: 4427908. DOI: 10.1177/1062860609333626. View

Drye E, Normand S, Wang Y, Ross J, Schreiner G, Han L . Comparison of hospital risk-standardized mortality rates calculated by using in-hospital and 30-day models: an observational study with implications for hospital profiling. Ann Intern Med. 2012; 156(1 Pt 1):19-26. PMC: 3319769. DOI: 10.7326/0003-4819-156-1-201201030-00004. View

Parente S, McCullough J . Health information technology and patient safety: evidence from panel data. Health Aff (Millwood). 2009; 28(2):357-60. DOI: 10.1377/hlthaff.28.2.357. View

Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E . Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006; 144(10):742-52. DOI: 10.7326/0003-4819-144-10-200605160-00125. View

Amarasingham R, Plantinga L, Diener-West M, Gaskin D, Powe N . Clinical information technologies and inpatient outcomes: a multiple hospital study. Arch Intern Med. 2009; 169(2):108-14. DOI: 10.1001/archinternmed.2008.520. View

Cram P, Lu X, Kaboli P, Vaughan-Sarrazin M, Cai X, Wolf B . Clinical characteristics and outcomes of Medicare patients undergoing total hip arthroplasty, 1991-2008. JAMA. 2011; 305(15):1560-7. PMC: 3108186. DOI: 10.1001/jama.2011.478. View

10.

Elixhauser A, Steiner C, Harris D, Coffey R . Comorbidity measures for use with administrative data. Med Care. 1998; 36(1):8-27. DOI: 10.1097/00005650-199801000-00004. View

11.

Miller A, Tucker C . Can health care information technology save babies?. J Polit Econ. 2011; 119(2):289-324. DOI: 10.1086/660083. View

12.

Longhurst C, Parast L, Sandborg C, Widen E, Sullivan J, Hahn J . Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2010; 126(1):14-21. DOI: 10.1542/peds.2009-3271. View

13.

Moskop J, Sklar D, Geiderman J, Schears R, Bookman K . Emergency department crowding, part 2--barriers to reform and strategies to overcome them. Ann Emerg Med. 2008; 53(5):612-7. DOI: 10.1016/j.annemergmed.2008.09.024. View

14.

Borzekowski R . Measuring the cost impact of hospital information systems: 1987-1994. J Health Econ. 2009; 28(5):938-49. DOI: 10.1016/j.jhealeco.2009.06.004. View

15.

Lin H, Tian W, Chen C, Liu T, Tsai S, Lee H . The association between readmission rates and length of stay for schizophrenia: a 3-year population-based study. Schizophr Res. 2006; 83(2-3):211-4. DOI: 10.1016/j.schres.2006.01.012. View

16.

Koppel R, Metlay J, Cohen A, Abaluck B, Russell Localio A, Kimmel S . Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005; 293(10):1197-203. DOI: 10.1001/jama.293.10.1197. View

17.

DesRoches C, Campbell E, Vogeli C, Zheng J, Rao S, Shields A . Electronic health records' limited successes suggest more targeted uses. Health Aff (Millwood). 2010; 29(4):639-46. DOI: 10.1377/hlthaff.2009.1086. View

18.

Himmelstein D, Wright A, Woolhandler S . Hospital computing and the costs and quality of care: a national study. Am J Med. 2009; 123(1):40-6. DOI: 10.1016/j.amjmed.2009.09.004. View

19.

Rosko M . Performance of US teaching hospitals: a panel analysis of cost inefficiency. Health Care Manag Sci. 2004; 7(1):7-16. DOI: 10.1023/b:hcms.0000005393.24012.1c. View

20.

Kuo Y, Goodwin J . Association of hospitalist care with medical utilization after discharge: evidence of cost shift from a cohort study. Ann Intern Med. 2011; 155(3):152-9. PMC: 3196599. DOI: 10.7326/0003-4819-155-3-201108020-00005. View