Meaningful Use and Hospital Performance on Post‐Acute Utilization Indicators

Ph.D., M.P.A. Yanick N. Brice; Joynt, M.P.H. Karen E.; Tompkins, Christopher P.; Ritter, Grant

doi:10.1111/1475-6773.12677

Cited by 6 publications

(2 citation statements)

References 52 publications

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“…This finding provides among the strongest evidence supporting the potential for interoperable health information technology to reduce readmissions. Although many hospitals use EHRs as part of their strategy to reduce readmissions, 58 the results of earlier studies generally have not found a relationship between adoption of these systems and readmissions, [59][60][61][62][63][64] with the exception of analyses based on cross-sectional or descriptive study designs. 59,65,66 This study's focus on the general adult patient population, rather than specifically focusing on Medicare beneficiaries, may explain some of the difference in our findings, as has been the case with studies examining the relationship between EHRs and patient safety among a broader adult population.…”

Section: Discussionmentioning

confidence: 99%

Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

Vest

Unruh

Freedman

et al. 2019

Journal of the American Medical Informatics Association

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Objective Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. Materials and Methods The association between unplanned 30-day readmissions among adult patients and adoption of enterprise HIE or a single vendor environment was measured in a panel of 211 system-member hospitals from 2010 through 2014 using fixed-effects regression models. Sample hospitals were members of health systems in 7 states. Enterprise HIE was defined as self-reported ability to exchange information with other members of the same health system who used different EHR vendors. A single EHR vendor environment reported exchanging information with other health system members, but all using the same EHR vendor. Results Enterprise HIE adoption was more common among the study sample than EHR (75% vs 24%). However, adoption of a single EHR vendor environment was associated with a 0.8% reduction in the probability of a readmission within 30 days of discharge. The estimated impact of adopting an enterprise HIE strategy on readmissions was smaller and not statically significant. Conclusion Reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggests that HIE technologies can better support the aim of higher quality care. Additionally, health systems may benefit more from a single vendor environment approach than attempting to foster exchange across multiple EHR vendors.

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Section: Discussionmentioning

confidence: 99%

Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

Vest

Unruh

Freedman

et al. 2019

Journal of the American Medical Informatics Association

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show abstract

“…36 Also similar to CHCs, evidence for the relationship between hospital adoption of EHRs and enhanced EHR capabilities and quality of care is mixed. For example, while Brice and colleagues reported no difference in 30-day readmission rates for hospitals who met meaningful use stage 1 objectives compared to those who did not, 37 Adler-Milstein reported improvements in patient satisfaction and adherence to process measures when comparing performance in hospitals before and after EHR adoption. 38 Limited research has focused on hospitals' use of HIT for providing enabling services and engaging patients or its impact on quality.…”

Section: Discussionmentioning

confidence: 99%

Using Health IT to Coordinate Care and Improve Quality in Safety-Net Clinics

Kranz

Dalton

Damberg

et al. 2018

The Joint Commission Journal on Quality and Patient Safety

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Electronic health records systems and hospital clinical performance: a study of nationwide hospital data

Yuan

Dudley

Boscardin

et al. 2019

Journal of the American Medical Informatics Association

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Objective Electronic health records (EHRs) were expected to yield numerous benefits. However, early studies found mixed evidence of this. We sought to determine whether widespread adoption of modern EHRs in the US has improved clinical care. Methods We studied hospitals reporting performance measures from 2008–2015 in the Centers for Medicare and Medicaid Services Hospital Compare database that also reported having an EHR in the American Hospital Association 2015 IT supplement. Using interrupted time-series analysis, we examined the association of EHR implementation, EHR vendor, and Meaningful Use status with 11 process measures and 30-day hospital readmission and mortality rates for heart failure, pneumonia, and acute myocardial infarction. Results A total of 1246 hospitals contributed 8222 hospital-years. Compared to hospitals without EHRs, hospitals with EHRs had significant improvements over time on 5 of 11 process measures. There were no substantial differences in readmission or mortality rates. Hospitals with CPSI EHR systems performed worse on several process and outcome measures. Otherwise, we found no substantial improvements in process measures or condition-specific outcomes by duration of EHR use, EHR vendor, or a hospital’s Meaningful Use Stage 1 or Stage 2 status. Conclusion In this national study of hospitals with modern EHRs, EHR use was associated with better process of care measure performance but did not improve condition-specific readmission or mortality rates regardless of duration of EHR use, vendor choice, or Meaningful Use status. Further research is required to understand why EHRs have yet to improve standard outcome measures and how to better realize the potential benefits of EHR systems.

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Meaningful Use and Hospital Performance on Post‐Acute Utilization Indicators

Cited by 6 publications

References 52 publications

Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions

Using Health IT to Coordinate Care and Improve Quality in Safety-Net Clinics

Electronic health records systems and hospital clinical performance: a study of nationwide hospital data

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