Nov 30, 2010
The Health Information Technology for Economic and Clinical Health Act of 2009 includes funds to stimulate adoption of health information technology, particularly electronic health records (EHRs), reflecting the general consensus that widespread adoption of information technology will increase efficiency and improve patient care. Approximately $30 billion in Medicare and Medicaid incentives will be paid out over the life of the program, mostly to hospitals that can demonstrate "meaningful use" of a "certified" EHR.
Will installing a new EHR, or improving the capabilities of an existing one, improve quality over time? To answer this question, RAND researchers integrated extensive data from 2003 and 2006 on EHR adoption, hospital characteristics, and hospital quality in nearly 2,100 hospitals. They examined how EHRs affected 17 measures of hospital process quality across three common clinical conditions: acute myocardial infarction (AMI), heart failure, and pneumonia. EHRs were placed in tiers depending on their capabilities; top-tier hospitals were those with an operational computerized provider order entry system (an advanced EHR), because such a system facilitates decision support where care is being provided. Study findings provide the following insights about the potential effects of EHRs on health care quality:
Better metrics for assessing what constitutes meaningful use should help to identify which elements of EHRs have the greatest effect on quality of care.