Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements

Hamadi, Hanadi; Niazi, Shehzad K.; Zhao, Mei; Spaulding, Aaron

doi:10.1016/j.mayocpiqo.2022.05.001

Cited by 2 publications

(2 citation statements)

References 36 publications

(39 reference statements)

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“…Healthcare has been waiting for decades to achieve and reap the benefits of an integrated and interoperable network of digitized records, and many health systems and professionals have looked to the vendors of large integrated EHR systems to help realize that vision by bringing order to a messy patchwork of niche software and homegrown systems. 26 , 27 However, EHR transitions are always fraught with challenges. In this analysis, we have drawn attention to a major yet underappreciated potential consequence of the adoption of large, integrated EHR systems, with a particular emphasis on their implications for the EHR workforce.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings, which highlight an important potential downside to single-vendor integrated EHR systems, also need to be understood in the context of the many potential advantages of such systems. Single-vendor systems have been associated with greater use of functions that enable “organizational and clinical care evaluation” 26 and even with lower probabilities of unplanned readmission. 27 They have also been credited with establishing “de facto interface standards” that make it easier for employees to work in and adjust to different specialty settings within an organization, and improved communication and data sharing across specialty settings within an institution.…”

Section: Discussionmentioning

confidence: 99%

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From “Local Control” to “Dependency”: Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce

Brunner,

Anderson,

Mohr

et al. 2023

J GEN INTERN MED

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Background Healthcare systems that previously used either a single legacy electronic health record (EHR) system or a “best-of-breed” combination of products from multiple vendors are increasingly adopting integrated, single-vendor EHR systems. Though healthcare leaders are beginning to recognize the dramatic collateral consequences of these transitions, their impact on the EHR workforce — internal actors most closely involved in governing and supporting the EHR — is poorly understood. Objective Identify perceived impacts of adopting single-vendor, integrated EHR systems on the institutional EHR workforce. Design In this qualitative study, we conducted semi-structured phone interviews in four healthcare systems in the USA that had adopted an integrated EHR within the previous five years. Participants Forty-two staff members of four geographically and organizationally diverse healthcare systems, including 22 individuals with formal informatics roles. Approach Transcribed interviews were coded and analyzed using qualitative content analysis methods. Key Results Across organizations, participants described a loss of autonomy by the EHR workforce at the individual and institutional level following the adoption of an integrated EHR. We also identified references to transformations in four key professional functions of the EHR workforce: communication, governance, optimization, and education. Conclusions Transitions to integrated EHR systems can have important implications for the autonomy and professional functions of the EHR workforce. These findings may help institutions embarking on similar transitions better anticipate and prepare for these changes through such practices as revising job descriptions, strengthening EHR governance structures, and reinforcing pathways to engage frontline clinicians in supporting the EHR. Findings may also help institutions structure vendor contracts in a way that anticipates and mitigates loss of autonomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

From “Local Control” to “Dependency”: Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce

Brunner,

Anderson,

Mohr

et al. 2023

J GEN INTERN MED

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Value Implications of Sourcing Electronic Health Records: The Role of Physician Practice Integration

Bardhan

Bao

Ayabakan

2023

Information Systems Research

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Should hospitals source electronic health records (EHR) systems from a single vendor or multiple vendors to deliver high-value care? We study hospitals’ EHR sourcing strategies based on their degree of integration with physician practices and its impact on the value of healthcare delivered. We propose a novel framework to define healthcare value as the extent to which a hospital effectively expends clinical resources to deliver services that improve patient outcomes. Drawing on modular systems and transaction cost economics theories, we propose a moderated-mediation model that explores the pathways through which EHR sourcing strategies can create value in healthcare. We test our research hypotheses on a large, longitudinal sample of U.S. hospitals and observe that hospitals with EHR configurations closer to single sourcing strategies exhibit greater health information sharing compared with hospitals with multisourced EHR systems. Furthermore, we find that hospital-physician practice integration moderates the impact of single sourcing on health information sharing, which in turn, improves value. Specifically, tighter integration between hospitals and physician practices can create greater value if it is aligned with hospitals’ EHR sourcing strategies. As the healthcare industry moves toward value-based payment reform, our findings provide a useful roadmap to practitioners and policy makers to improve the performance of hospitals and healthcare providers. History: Rajiv Kohli, Senior Editor; Sunil Wattal, Associate Editor. Funding: I.R. Bardhan thanks the Foster Parker Centennial Professorship and the Dean’s Research Excellence Grant at the McCombs School of Business at UT Austin for generous financial support. C. Bao thanks the Spears Fellowship at Oklahoma State University for financial support. Supplemental Material: The online appendix is available at https://doi.org/10.1287/isre.2022.1183 .

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Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements

Cited by 2 publications

References 36 publications

From “Local Control” to “Dependency”: Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce

From “Local Control” to “Dependency”: Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce

Value Implications of Sourcing Electronic Health Records: The Role of Physician Practice Integration

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