The Effect of Access to Electronic Health Records on Throughput Efficiency and Imaging Utilization in the Emergency Department

Knepper, Matthew; Castillo, Maurício; Chan, Theodore C.; Guss, David A.

doi:10.1111/1475-6773.12695

Cited by 16 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[10][11][12][13][14][15][16] Other studies have reported that the introduction of EHR may result in less orders for unnecessary tests and imaging and can possibly influence confidence in diagnosis. 17,18 The difficulty in reaching a conclusion as to benefits of EHR is due to multiple factors, these include a wide spectrum of commercially available EHR systems, mixed taxonomy utilized by different studies, intrinsic site and utilization differences and an absence of standardized measure in the assessment of EHR performance. 19 A systematic review found that the same taxonomy in EHR literature had variable meanings depending on the author.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies suggest that there may be improvements in length of stay, mortality, inpatient rate of infections, adherence to guidelines, rate of medication errors, costs and utilization of physician time . Other studies have reported that the introduction of EHR may result in less orders for unnecessary tests and imaging and can possibly influence confidence in diagnosis …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementation of electronic health records systems in surgical units and its impact on performance

Liu

Edye

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Electronic health records (EHR) systems have been utilized in New South Wales for more than a decade; however, there is no agreement as to what clinical benefits they provide. This study aims at determining whether the introduction of EHR systems resulted in changes in documentation quality and other markers of clinical performance such as post-operative length of stay (PO LOS), use of imaging modality, rates of readmission and morbidity. Methods: A before and after study was conducted utilizing both written and electronic patient documentation in a single surgical ward. Patients who underwent appendicectomy at Blacktown Hospital had inpatient documentation collated at three distinct time-points. Documentation was then assessed against the QNOTE assessment criteria. Other markers of clinical performance assessed included PO LOS, ultrasound use, computed tomography use, rate of readmission, rate of morbidity and rate of positive histological findings. Results: There was a significant (P = 0.001) improvement in QNOTE score between group 1 (6 months prior to the implementation of EHR) and group 3 (12 months after the implementation of EHR) of 9 points. PO LOS was reduced following the implementation of EHR from 1.94 to 1.37 days (P = 0.001). Conclusion: This study demonstrated that following the implementation of EHR system in an inpatient surgical ward, notation quality improved. It was also found that the implementation of EHR was associated with a decrease in PO LOS.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implementation of electronic health records systems in surgical units and its impact on performance

Liu

Edye

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Evidence on the effects of HIT on efficiency also shows mixed results. HIT is found to reduce costs [2] [30] [36] [38] and the number of radiology exams [37] [38]. However, studies also suggest that HIT increases hospital costs and nurse staffing levels [6] [29].…”

Section: Efficiencymentioning

confidence: 99%

“…For a complete overview of the studies and these effects of HIT, see Table 3. no effect [38] Table 3. HIT functionalities and effects on medical professional satisfaction.…”

Section: Medical Professional Satisfactionmentioning

confidence: 99%

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Westerhof,

Hilhorst,

Bos

2024

Health

View full text Add to dashboard Cite

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a comprehensive database search. To organise, categorise and synthesise the existing literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured; 2) use and immediate outcomes of HIT functionalities; 3) different performance indicators and how HIT functionalities affect them; and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly measuring the use rate of HIT. We identified five dimensions of hospital performance indicators. Every dimension showed mixed results; however, in general, HIT has a positive impact on mortality and patient readmissions. We found several hospital characteristics that may affect the relationship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regarding the functionalities, use and effects of HIT implementation in hospitals. Given our research outcomes, we suggest future research opportunities to improve understanding of how HIT affects hospital performance.

show abstract

“…Some of the studies from the current literature exhibited a trend that EHR adoption and financial outcomes have a nonlinear relationship [16,17], and some of the studies indicated that EHR adoption resulted in improved financial outcomes for health care organizations that adopted it over time [14,18]. The literature suggests that improvement in costs and revenues is the result of improved clinical outcomes such as reduction of redundant tests [19], reduction of medication and hospital bed-related costs [20], improved ability to capture charges [15], and improved decision support systems [21]. Since this study focuses on combining both financial and clinical outcomes into 1 conceptual model, for the purpose of this study, the capital project investment (EHR adoption in this case) and improvement in financial returns (financial outcomes), tenets of the corporate financial theory of the firm, with an addition of the clinical outcomes, are integrated into a conceptual framework.…”

Section: Conceptual Framework and Hypothesesmentioning

confidence: 99%

Value of Electronic Health Records Measured Using Financial and Clinical Outcomes: Quantitative Study

Modi,

Feldman,

Berner

et al. 2024

JMIR Med Inform

View full text Add to dashboard Cite

Background The Health Information Technology for Economic and Clinical Health Act of 2009 was legislated to reduce health care costs, improve quality, and increase patient safety. Providers and organizations were incentivized to exhibit meaningful use of certified electronic health record (EHR) systems in order to achieve this objective. EHR adoption is an expensive investment, given the resources and capital that are invested. Due to the cost of the investment, a return on the EHR adoption investment is expected. Objective This study performed a value analysis of EHRs. The objective of this study was to investigate the relationship between EHR adoption levels and financial and clinical outcomes by combining both financial and clinical outcomes into one conceptual model. Methods We examined the multivariate relationships between different levels of EHR adoption and financial and clinical outcomes, along with the time variant control variables, using moderation analysis with a longitudinal fixed effects model. Since it is unknown as to when hospitals begin experiencing improvements in financial outcomes, additional analysis was conducted using a 1- or 2-year lag for profit margin ratios. Results A total of 5768 hospital-year observations were analyzed over the course of 4 years. According to the results of the moderation analysis, as the readmission rate increases by 1 unit, the effect of a 1-unit increase in EHR adoption level on the operating margin decreases by 5.38%. Hospitals with higher readmission payment adjustment factors have lower penalties. Conclusions This study fills the gap in the literature by evaluating individual relationships between EHR adoption levels and financial and clinical outcomes, in addition to evaluating the relationship between EHR adoption level and financial outcomes, with clinical outcomes as moderators. This study provided statistically significant evidence (P<.05), indicating that there is a relationship between EHR adoption level and operating margins when this relationship is moderated by readmission rates, meaning hospitals that have adopted EHRs could see a reduction in their readmission rates and an increase in operating margins. This finding could further be supported by evaluating more recent data to analyze whether hospitals increasing their level of EHR adoption would decrease readmission rates, resulting in an increase in operating margins. Hospitals would incur lower penalties as a result of improved readmission rates, which would contribute toward improved operating margins.

show abstract

The Effect of Access to Electronic Health Records on Throughput Efficiency and Imaging Utilization in the Emergency Department

Abstract: EHR availability for ED patients is associated with a reduction in CT scans and cost savings but had no impact on throughput time or order frequency of other imaging studies.

Cited by 16 publications

References 26 publications

Implementation of electronic health records systems in surgical units and its impact on performance

Implementation of electronic health records systems in surgical units and its impact on performance

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Value of Electronic Health Records Measured Using Financial and Clinical Outcomes: Quantitative Study

Contact Info

Product

Resources

About