National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018

Classen, David C.; Holmgren, Anders; Co, Zoe; Newmark, Lisa P.; Seger, Diane L.; Danforth, Melissa; Bates, David W.

doi:10.1001/jamanetworkopen.2020.5547

Cited by 52 publications

(66 citation statements)

References 18 publications

(78 reference statements)

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“…The respondents agreed that they could accomplish their clinical tasks successfully in simple steps. The bene ts of usage empowered the care providers to perform timely and accurate care without misdiagnosis or prescribing the wrong medications [63]. As noted, the bene ts include ease of search and retrieval of past medical records of patients, well-structured and customized EHRs, fewer documentation errors, and convenience of use within the hospital facility.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Effects of Electronic Health Records System Adoption on the Performance of Malaysian Health Care Providers

Salleh

Abdullah

Zakaria

2020

Preprint

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Background: The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been effectively utilized is necessary, particularly regarding how it predicts the work performance of health care providers. Methods: Convenience sampling was employed for data collection in three government hospitals for seven months. A standardized efficacy survey for EHR systems was administered to primary health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Empirical data were assessed by employing partial least squares-structural equation modeling for hypothesis testing.Results: The results demonstrated that knowledge quality had the highest score for predicting performance and had a large effect size, whereas system compatibility was the strongest component of system quality. The findings indicated that EHR systems supported the clinical tasks and workflows of care providers, which increased system quality, whereas increased quality of knowledge improved user performance. Conclusion: Given these findings, knowledge quality and effective use should be incorporated into the evaluation of EHR system efficacy in health institutions. Data mining features can be integrated into current systems for easily and systematically generating health populations and disease trend analysis, improving clinical knowledge of care providers and aiding in maintaining their productivity. The validated survey instrument can be further tested with empirical surveys in other public and private hospitals with different interoperable EHR systems.

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Section: Discussionmentioning

confidence: 99%

Evaluating the Effects of Electronic Health Records System Adoption on the Performance of Malaysian Health Care Providers

Salleh

Abdullah

Zakaria

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The respondents agreed that they could accomplish their clinical tasks successfully in simple steps. The bene ts of the usage have empowered the care providers to perform timely and accurate care without committing any misdiagnosis or prescribing wrong medications [57]. As noted, the bene ts include ease of search and retrieval of past medical records of patients, well-structured and customized EHRs, fewer documentation errors, and convenience of use within the hospital facility.…”

Section: Discussionmentioning

confidence: 99%

Evaluating The Performance Of Malaysian Health Care Providers With Partial Least Squares Path Modeling

Salleh¹,

Abdullah²,

Zakaria³

2020

Preprint

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Background: The Ministry of Health Malaysia invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been utilized effectively is necessary, particularly on how it predicts the work performance of the health care providers. Methods: Convenience sampling was employed for data collection in three government hospitals for seven months. A standardized effectiveness survey for EHR systems was administered to health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Power analysis was conducted before and after the study to ensure adequate sample sizes and sufficient power. The empirical data was assessed by employing partial least squares-structural equation modeling for hypotheses testing. Results: As a results, knowledge quality had the highest score in predicting performance and had a large effect size, whereas system compatibility became the strongest component of system quality. The findings indicated that EHR systems supported the clinical tasks and workflows of care providers, which increased system quality, whereas increased quality of knowledge improved user performance. Conclusion: Therefore, knowledge quality and effective use should be incorporated into the evaluation study of EHR system effectiveness in health institutions. Data mining feature can be integrated into current systems for generating health populations and disease trend analysis easily and systematically, therefore improving clinical knowledge of care providers and effective use to maintain their productivity. The validated survey instrument can be further tested with empirical surveys in other public and private hospitals with different interoperable EHR systems.

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“…6,7 Not all EHR systems are created equal when it comes to configuration of alerts. 8 Within the same EHR, different institutions and clinics can implement the same tools in different ways, and at different points in the EHR lifecycle. Finally, training and communication of end users to any new CDS can vary greatly from site to site.…”

Section: Background and Significancementioning

confidence: 99%

Reducing Inappropriate Outpatient Medication Prescribing in Older Adults across Electronic Health Record Systems

et al. 2020

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Background The American Geriatrics Society recommends against the use of certain potentially inappropriate medications (PIMs) in older adults. Prescribing of these medications correlates with higher rates of hospital readmissions, morbidity, and mortality. Vanderbilt University Medical Center previously deployed clinical decision support (CDS) to decrease PIM prescribing rates, but recently transitioned to a new electronic health record (EHR). Objective The goal of this study was to evaluate PIM prescribing rates for older adults before and after migration to the new EHR system. Methods We reviewed prescribing rates of PIMs in adults 65 years and older, normalized per 100 total prescriptions from the legacy and new EHR systems between July 1, 2014 and December 31, 2019. The PIM prescribing rates before and after EHR migration during November 2017 were compared using a U-chart and Poisson regression model. Secondary analysis descriptively evaluated the frequency of prescriber acceptance rates in the new EHR. Results Prescribing rates of PIMs decreased 5.2% (13.5 per 100 prescriptions to 12.8 per 100 prescriptions; p < 0.0001) corresponding to the implementation of alternatives CDS in the legacy EHR. After migration of the alternative CDS from the legacy to the new EHR system, PIM prescribing rates dropped an additional 18.8% (10.4 per 100 prescriptions; p < 0.0001). Acceptance rates of the alternative recommendations for PIMs was low overall at 11.1%. Conclusion The prescribing rate of PIMs in adults aged 65 years and older was successfully decreased with the implementation of prescribing CDS. This decrease was not only maintained but strengthened by the transition to a new EHR system.

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National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018

Abstract: IMPORTANCE Despite the broad adoption of electronic health record (EHR) systems across the continuum of care, safety problems persist. OBJECTIVE To measure the safety performance of operational EHRs in hospitals across the country during a 10-year period.

Cited by 52 publications

References 18 publications

Evaluating the Effects of Electronic Health Records System Adoption on the Performance of Malaysian Health Care Providers

Evaluating the Effects of Electronic Health Records System Adoption on the Performance of Malaysian Health Care Providers

Evaluating The Performance Of Malaysian Health Care Providers With Partial Least Squares Path Modeling

Reducing Inappropriate Outpatient Medication Prescribing in Older Adults across Electronic Health Record Systems

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