EHR Quality Improvement

Electronic Health Record Adoption and Quality Improvement in US Hospitals

This report analyzes approximately 2000 US hospitals with varying levels of EHR capability in an attempt to determine the quality improvements derived from "use" of EHRs. While the conclusion is discouraging -- EHR implementation has limited effects on quality improvements in hospitals -- it is important to analyze the documented limitations of the study to determine a future solution to improving the results.

Limitation 1: EHR implementation has different effects on quality improvement for conditions other than the 3 studied.

This limitation is a barrier to developing standards for measuring the effects of EHR quality improvement because of the amount of clinical data needed. Developing condition specific metrics is crucial to fully evaluate the quality improvement of EHR.

Limitation 2: Approach to measuring EHR capability did not account for the adequacy and frequency of EHR use or variation of EHR functionality between hospitals.

The report makes note that "Moving forward, metrics of meaningful use of an EHR should make it possible to better assess and identify which elements of EHR use have the greatest effect on clinical quality." This will be possible when more data becomes available, which will only occur when standards exist for measuring EHR quality improvement. Once standards are in place, it will be easier to identify the performing and lagging metrics.

The report lays solid framework for developing nationwide standards for measuring the effects of EHR use. The Office of the National Coordinator for Health Information Technology is responsible for delivering an effective standardized method and has the help of IT vendors and the health care community in doing so. The challenge will be to sync these standards with current vendor offerings while adapting future standards to technology changes.