Study links advanced EMR capabilities to lower mortality rates

Hospitals with advanced EMR capabilities tend to perform better, particularly with mortality rates, according to a study from HIMSS Analytics and Healthgrades, an online data resource.

Using HIMSS Analytics’ EMR Adoption Model (EMRAM) and mortality rate measures for 19 unique procedures and conditions based on clinical cohorts, researchers found that hospitals with more advanced systems demonstrated significantly better actual mortality rates. Improvements were especially apparent for patients with heart attacks, respiratory failure and small intestine surgery, according to the study. Overall, a total of 4,583 facility records were selected from the HIMSS Analytics Database, representing the total number of facilities with complete data from 2010 through 2012.

“It’s the next step in the long journey to get value out of the electronic medical record and document that value,” Richard Skinner, CIO and chief technology officer at the University of Virginia Health System and HIMSS Analytics board member, told Clinical Innovation + Technology. “This has been a long journey and we still have a long way to go.”

Skinner compared the healthcare experience to that of Fortune 500 companies, which muddled through the advent of enterprise resource planning (ERP) systems in the late 1980s and 1990s. “You’d hear all kinds of horror stories of companies spending tens or hundreds of millions of dollars and not getting any value,” he said, adding that by the early 2000s, every single Fortune 500 company improved their efficiency and performance with these systems.

Healthcare is likewise going through its own experience of adopting and optimizing electronic systems. According to Skinner, EMR functions that are driving improved hospital performance include:

1. The ability to capture clinical information, which helps establish patient co-morbidities and other risks so clinicians can better manage patients seen in the hospital, resulting in more positive predicted clinical outcomes.
2. Support and linkage of clinical flow.
3. Clinical decision support.

“Hospitals should take this study as an indication that they can obtain clinical value and better outcomes for their patients not solely through the use of an EMR, but by focusing on optimizing use of their EMR,” he said. “Now that we are seeing documentation in value, it can only get better, but there is work that remains to be done.”

Skinner stressed that the results are preliminary, and much remains to be understood on why these improvements happened and why results varied between service lines. However, “we’re going to see more and more of these studies, especially with the money and effort going into adoption. The focus on information and clinical decision making is bound to improve outcomes,” he said.