Choosing an electronic health record (EHR) vendor can determine a hospital's ability to improve performance based on meaningful use criteria, according to a study published in the Journal of Informatics in Health and Biomedicine.

Federal EHR certification programs were designed to provide hospitals with a baseline in providing high quality care while meeting meaningful use criteria, but variations in EHR performance persist. In this study, researchers evaluated the role EHR vendors played in hospital performance.

Researchers created a national hospital sample from the public use files of the Office of the National Coordinator for Health Information Technology EHR Products Used for Meaningful Use Attestation public and the Centers for Medicare & Medicaid Services Medicare EHR Incentive Program Eligible Hospitals. The sample was then evaluated using regression models to identify any correlation between vendor and hospital performance on six stage and two meaningful use criteria.

Results showed a significant correlation between specific vendors and levels of performance in all six meaningful use criteria. Epic systems provided significantly higher performance on five of six criteria while other vendors showed mixed results. Overall, EHR vendor choice accounted for a 7 to 34 percent difference in performance across the six meaningful use criteria.

“Vendor choice accounts for a meaningful proportion of variation in hospital meaningful use performance, and specific vendors are consistently associated with higher or lower performance across criteria,” concluded first author A. Jay Holmgren of Harvard Business School and colleagues. “Our results suggest that policy-makers should improve the certification process by including more real-world scenario testing and provider feedback or ratings to reduce this variation. Hospitals can use these results to guide interactions with vendors.”