The long-term financial impact of electronic health record implementation

Howley, Michael; Chou, Edgar; Hansen, Nancy K.; Dalrymple, Prudence W.

doi:10.1136/amiajnl-2014-002686

Cited by 38 publications

(31 citation statements)

References 17 publications

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“…In one study, costs were recaptured within 16 months, with ongoing annual savings and no adverse effect on efficiency 97. In another, overall productivity increased by around 5% per year post-full EPR implementation98; whilst productivity may initially fall, billing income may increase due to improved coding 99. Furthermore, cost-savings include reduced medication errors, improved implementation of clinical practice guidelines, enhanced infection prevention and cost-effective diagnostic testing100; order-set creation and care pathway redesign have significant benefits 101.…”

Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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BackgroundNumerous studies have examined factors related to success, failure and implications of electronic patient record (EPR) system implementations, but usually limited to specific aspects.ObjectiveTo review the published peer-reviewed literature and present findings regarding factors important in relation to successful EPR implementations and likely impact on subsequent clinical activity.MethodLiterature review.ResultsThree hundred and twelve potential articles were identified on initial search, of which 117 were relevant and included in the review. Several factors were related to implementation success, such as good leadership and management, infrastructure support, staff training and focus on workflows and usability. In general, EPR implementation is associated with improvements in documentation and screening performance and reduced prescribing errors, whereas there are minimal available data in other areas such as effects on clinical patient outcomes. The peer-reviewed literature appears to under-represent a range of technical factors important for EPR implementations, such as data migration from existing systems and impact of organisational readiness.ConclusionThe findings presented here represent the synthesis of data from peer-reviewed literature in the field and should be of value to provide the evidence-base for organisations considering how best to implement an EPR system.

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Section: Resultsmentioning

confidence: 99%

What to expect from electronic patient record system implementation: lessons learned from published evidence

Priestman

Sridharan

Vigne

et al. 2018

BMJ Health Care Inform

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“…The authors concluded that the longer-time productivity and financial performance of the study practices were not affected by the EHR implementation; however, the short-term negative impact was evident. In another study, Howley et al (2015) analyzed the productivity and reimbursement data collected longitudinally from 30 ambulatory care practices for 2 years after implementing an EHR system [142]. The authors found that, by comparing each site to their pre-EHR baseline, the study practices saw fewer patients with the EHR, but their reimbursements significantly increased.…”

Section: G Financial Impactmentioning

confidence: 99%

A Survey of the Literature on Unintended Consequences Associated with Health Information Technology: 2014–2015

Zheng¹,

Abraham²,

Novak³

et al. 2016

Yearb Med Inform

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SummaryObjective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.

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“…eHealth includes a broad array of health-related information and communication technologies (ICT) such as electronic health records, electronic prescribing systems, health information exchange systems and clinical decision support systems. Several studies have indicated that the use of eHealth technologies can lead to potential benefits in improving the quality and delivery of healthcare services, enhancing cost savings, increasing revenue, facilitating patient safety, reducing waiting times and create greater patient engagement during the course of their care [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Governance structures impact on eHealth

Kierkegaard

2015

Health Policy and Technology

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The long-term financial impact of electronic health record implementation

Abstract: Practice reimbursements increased after EHR implementation, but there was a long-term decrease in the number of patient visits seen in this ambulatory practice context.

Cited by 38 publications

References 17 publications

What to expect from electronic patient record system implementation: lessons learned from published evidence

What to expect from electronic patient record system implementation: lessons learned from published evidence

A Survey of the Literature on Unintended Consequences Associated with Health Information Technology: 2014–2015

Governance structures impact on eHealth

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