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Study Raises Questions About Degree of Effectiveness of EHR Use

Thursday December 30, 2010
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The use of electronic health records does not generate wide-ranging improvement in the quality of care at U.S. hospitals, according to data compiled and analyzed by the nonprofit RAND Corp.

Researchers looked at quality of care for heart failure, heart attack and pneumonia at 2,021 hospitals between 2003 and 2007. The number represents about half of all non-federal acute care hospitals in the U.S.

Quality improvement rates during the time span for heart failure patients were 2.6% at hospitals with basic EHR over those without EHR, but 3.0% lower at hospitals that had upgraded to an advanced EHR system than at hospitals with no EMR system. For heart attack patients, hospitals with advanced EHR systems had a 0.9% lower quality improvement rate than hospitals without EHR.

Hospitals with advanced EHR systems also had quality improvement rates that were 1.2% lower for heart attack patients and 2.8% lower for heart failure patients when compared with hospitals with more basic EHR systems. The analysts reported no significant difference in the quality improvement rates for pneumonia patients between hospitals with EHR and those without.

"We are concerned that the standard methods for measuring hospital quality will not be appropriate for measuring the clinical effects of EHR adoption," the authors wrote. "The generally high levels of performance on the Hospital Compare database measures are to be celebrated, but in going forward, these high levels of performance will make it difficult to detect the effect of EHR adoption on hospital quality."

The study was published online Dec. 23 in the American Journal of Managed Care: www.ajmc.com/supplement/managed-care/2010/AJMC_10dec_HIT/AJMC_10decHIT_Jones_SP64to71.

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