- According to researchers from Loyola University Medical Center, hospital EHR use can counteract the weekend effect, a phenomenon wherein health outcomes for patients following weekend surgeries compared to those of their weekday counterparts.
The research published in JAMA Surgery built on a previous study into the benefits of fully implemented EHR systems for mitigating temporal disparities in health outcomes for patients undergoing urgent weekend surgeries.
“Implementation of EHR system is one mechanism to help hospitals combat an important temporal disparity of care, the weekend effect, for patients undergoing urgent general surgical procedures,” write Kothari et al. “Specific components of EHR systems, including electronic operating room scheduling and electronic bed management systems, are most strongly associated with decreasing the odds of the weekend effect.”
The researchers reviewed of 2011 patient-level data from the Healthcare Cost and Utilization Project State Inpatient Databased sponsored by the Agency of Healthcare Research and Quality and health IT adoption data from HIMSS Analytics. Hospital data came by way of the American Hospital Association Survey Database.
A total of 2,979 patients fit the criteria for the study — those receiving a weekend appendectomy, acute hernia repair or cholecystectomy (gallbladder removal) — with 946 (32 percent) having experienced the weekend effect.
As for the primary outcome used to determine the weekend effect, Kothari et al. keyed in on hospital length of stay. The team of researchers found that patients at hospitals with electronic operating room scheduling were one-third less likely to experience the weekend effect than patients at hospitals with paper-based scheduling. Similarly, patients at hospitals with electronic bed-management systems were 35 percent less likely to experience the weekend effect than those at hospitals without that EHR capability.
“Together, these data illustrate an important relationship that may exist between EHR systems and temporal care disparities in nonelective surgical settings,” Kothari et al. concluded.
Researchers relied on Loyola’s predictive analytics program which allow researchers to mine big data for the purposes of predicting health outcomes.
"We're now able to ask and answer a broad range of questions that could significantly help improve patient care and reduce costs," Kuo, who serves as Loyola University Health System Department of Survey Chair and leads the university analytics group One to Map Analytics, said in an official statement midweek.
As part of previous study published in Annals of Surgery, a team of Loyola researchers observed five factors contributing to patients avoiding the weekend effect:
- full adoption of electronic medical records
- home health programs
- pain management programs
- increased registered nurse-to-bed ratios
- inpatient physical rehabilitation.
The most recent study set out to identify the components of hospital EHR technology that help mitigate the weekend effect.
Earlier this month, National Academy of Medicine’s Vital Directions for Health and Health Care Initiative published four policy priorities for providing quality care at a lower cost, which included the ability of providers to share EHR data as essential to realizing the “economic and clinical benefits” of EHR technology.
“The technical capacity exists for continuous communication and learning throughout health care, ranging from the activities of different clinicians and institutions, to the operation and interplay among relevant medical devices, to readings from mobile biomonitoring devices,” the NAM initiative noted. “Taking full advantage of this transformative capacity requires comprehensive strategy and action to strengthen data infrastructure, build public trust around data privacy and security, and harmonize inconsistent state and local policies on data use and sharing.”
While improved EHR use has the potential to improve patient health outcomes, it likewise poses problems for healthcare organizations working to address physician burnout. A group of leading healthcare CEOs recently called on the industry to collaborate on improving EHR usability to address this public health crisis.