- The ongoing debate over whether EHR use improves or impedes patient care has persisted for nearly ten years.
While the technology is unpopular among many of its users, a recent study by Wani et al. offers evidence to suggest the technology may be yielding small but notable improvements in patient health outcomes.
As part of the Journal of Operations Management study, researchers analyzed patient EHR data from California’s Office of Statewide Health Planning and Development (OSHPD). The health records detailed patient stays spanning 2010-2013.
The dataset included discharge information, patient demographic information, dates of admission, procedures, diagnoses-related group codes, and the type of procedures conducted.
The team divided California hospitals included in the dataset into three groups: hospitals that successfully attested to meaningful use, hospitals that adopted full EHR functionality, and hospitals that have not adopted all functionality required for meaningful use attestation.
Researchers combined this data with information from CMS related to meaningful use attestation, as well as data from HIMSS that included information on various technologies adopted by California hospitals. In total, researchers analyzed patient EHRs from 269 hospitals.
Ultimately, the team found overall length of stay decreased by an average of 3 percent among all patients who received treatment at hospitals that successfully attested to meaningful use.
“If a hospital treats about 10,000 patients in a year, this alone translates to an annual savings of $900,000 for each hospital,” noted researchers.
Additionally, researchers determined hospitals that successfully attested to meaningful use had lower rates of hospital readmissions than hospitals that did not adopt the EHR functionality necessary to fulfill the program’s reporting requirements.
“This is an added benefit to hospitals that might otherwise face additional penalties under the CMS’ Hospital Readmission Reduction Program,” wrote researchers. “Thus, meaningful assimilation of EHRs is an important component in achieving the triple aim of care, health, and cost in the patient population.”
Researchers also found hospitals that fulfilled meaningful use requirements had lower rates of readmissions than hospitals that adopted full EHR functionality, including functionality that was not required by meaningful use.
“Collectively, our results show that meaningful-EHR assimilation, based on first stage requirements that mandate hospitals capture patient information systematically in an electronic format and use built-in treatment protocols for treating these patients, really helps in reducing the overall length of stay as well as readmission rates,” researchers stated.
Furthermore, researchers found EHR use is especially effective in reducing length of stays for patients with a higher degree of health complexities.
Hospitals that successfully attested to meaningful use saw a 3.5 percent reduction in average length of stay for patients with comorbidities.
Overall, the team emphasized that effectively leveraging key EHR functionality is more beneficial to patient care than adopting a large volume of EHR tools.
“Even greater benefits are likely to accrue when hospitals become certified for later stages of meaningful use that may focus on information exchanges among hospitals, patient self-management tools, and greater decision support for high-priority conditions,” wrote researchers.
While EHR use may help to reduce length of stays and readmissions, other research has associated specific EHR functionality with patient safety risks.
A 2018 JAMA study found medication lists are often inaccurate and incomplete, which may open the door for adverse drug reactions, un-informed clinical decision-making, and poor medication monitoring.
The team found about 22 percent of medications used for 1,346 patients were not shown as prescribed in the patients’ EHR medication lists.
Accurately identifying, quantifying, and updating patient medication lists can help to improve clinical decision-making and reduce the likelihood of adverse drug reactions.