The adoption of an electronic health record did not improve A1c values in Type 2 diabetes

Burke, Harry B.; Becher, Dorothy; Hoang, Albert; Gimbel, Ronald W.

doi:10.14236/jhi.v23i1.144

Cited by 8 publications

(6 citation statements)

References 20 publications

(32 reference statements)

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“…For example, introduction and gap categories were generated as they assisted in the writing of the introduction and gap and supplied context for this review of literature; however, quotations included in these categories did not necessarily factor into the results presented. (36) ("electronic health record*":ti,ab,kw OR "electronic medical record*":ti,ab,kw OR "computerized health record*":ti,ab,kw OR "computerized medical record*":ti,ab,kw OR ehr:ti,ab,kw OR "electronic patient record*":ti,ab,kw OR "electronic health record":ti,ab,kw) AND (finance*:ti,ab,kw OR monetary:ti,ab,kw OR economic*:ti,ab,kw OR fiscal:ti,ab,kw OR "economic":ti,ab,kw) AND (clinical:ti,ab,kw OR quality:ti,ab,kw) AND ("follow-up studies":ti,ab,kw OR "follow up stud*":ti,ab,kw OR prognos*:ti,ab,kw OR predict*:ti,ab,kw OR course:ti,ab,kw OR "followup stud*":ti,ab,kw OR efficacy:ti,ab,kw OR complication:ti,ab,kw OR chang*:ti,ab,kw OR effective*:ti,ab,kw OR evaluat*:ti,ab,kw OR imptove*:ti,ab,kw OR indicat*:ti,ab,kw OR impact*:ti,ab,kw OR consequence*:ti,ab,kw OR development*:ti,ab,kw OR result*:ti,ab,kw OR outcome*:ti,ab,kw) AND (adopt*:ti,ab,kw OR implement*:ti,ab,kw) 0 (0) N/A 0 (0) ("electronic health records adoption":ti,ab,kw OR "ehr adoption":ti,ab,kw) AND "financial outcomes":ti,ab,kw 35 (3.6) Years: 2009-2019 42 (4.3) ("electronic health records adoption":ti,ab,kw OR "ehr adoption":ti,ab,kw) AND "financial":ti,ab,kw 3 (0.3) Years: 2009-2019 3 (0.3) ("electronic health records adoption":ti,ab,kw OR "ehr adoption":ti,ab,kw) AND "clinical outcomes":ti,ab,kw 95 (9.8) Years: 2009-2019 104 (10.7) ("electronic health records adoption":ti,ab,kw OR "ehr adoption":ti,ab,kw) AND "clinical":ti,ab,kw a N/A: not applicable. [22].…”

Section: Methodsmentioning

confidence: 99%

The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review

Modi

Feldman

2022

JMIR Med Inform

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Background Electronic health records (EHRs) are the electronic records of patient health information created during ≥1 encounter in any health care setting. The Health Information Technology Act of 2009 has been a major driver of the adoption and implementation of EHRs in the United States. Given that the adoption of EHRs is a complex and expensive investment, a return on this investment is expected. Objective This literature review aims to focus on how the value of EHRs as an intervention is defined in relation to the elaboration of value into 2 different value outcome categories, financial and clinical outcomes, and to understand how EHRs contribute to these 2 value outcome categories. Methods This literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The initial search of key terms, EHRs, values, financial outcomes, and clinical outcomes in 3 different databases yielded 971 articles, of which, after removing 410 (42.2%) duplicates, 561 (57.8%) were incorporated in the title and abstract screening. During the title and abstract screening phase, articles were excluded from further review phases if they met any of the following criteria: not relevant to the outcomes of interest, not relevant to EHRs, nonempirical, and non–peer reviewed. After the application of the exclusion criteria, 80 studies remained for a full-text review. After evaluating the full text of the residual 80 studies, 26 (33%) studies were excluded as they did not address the impact of EHR adoption on the outcomes of interest. Furthermore, 4 additional studies were discovered through manual reference searches and were added to the total, resulting in 58 studies for analysis. A qualitative analysis tool, ATLAS.ti. (version 8.2), was used to categorize and code the final 58 studies. Results The findings from the literature review indicated a combination of positive and negative impacts of EHRs on financial and clinical outcomes. Of the 58 studies surveyed for this review of the literature, 5 (9%) reported on the intersection of financial and clinical outcomes. To investigate this intersection further, the category “Value–Intersection of Financial and Clinical Outcomes” was generated. Approximately 80% (4/5) of these studies specified a positive association between EHR adoption and financial and clinical outcomes. Conclusions This review of the literature reports on the individual and collective value of EHRs from a financial and clinical outcomes perspective. The collective perspective examined the intersection of financial and clinical outcomes, suggesting a reversal of the current understanding of how IT investments could generate improvements in productivity, and prompted a new question to be asked about whether an increase in productivity could potentially lead to more IT investments.

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Section: Methodsmentioning

confidence: 99%

The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review

Modi

Feldman

2022

JMIR Med Inform

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“…It has been found that information alone does not lead to an improvement in care. A study5 looking at how the use of an electronic health record (EHR) affected the quality of care for patients with diabetes found that EHR use did not improve the clinical quality of diabetic care.…”

Section: Dave’s Storymentioning

confidence: 99%

Healthcare Utopia or Dystopia?

Bond

2017

jhi

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“…Two papers touch on challenges around clinically important areas: Burke et al, around diabetes2 and Lin et al, about kidney disease 3. Burke’s paper shows a “blip,” a deterioration in diabetes control (measured using glycated haemoglobin – HbA1c) after a computerised medical record system (CMR) was implemented.…”

Section: Benefits and Disbenefits Of Cmr System Implementation And Admentioning

confidence: 99%

In this issue - Benefits and disbenefits of computerised medical records (CMR): clinical, patient-centred, implementation and sociotechnical factors

Lusignan

2016

jhi

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The adoption of an electronic health record did not improve A1c values in Type 2 diabetes

Cited by 8 publications

References 20 publications

The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review

The Value of Electronic Health Records Since the Health Information Technology for Economic and Clinical Health Act: Systematic Review

Healthcare Utopia or Dystopia?

In this issue - Benefits and disbenefits of computerised medical records (CMR): clinical, patient-centred, implementation and sociotechnical factors

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