Study: Does the implementation of EHRs affect patient outcome?

Physicians and healthcare providers alike can all agree on the frustrations that implementing EHRs cause, but does installing this technology affect patients care? Almost surprisingly, it does not.

In a study published by the BMJ, researchers set out to see if the process of implementing EHRs has an effect on patient outcomes of mortality, readmissions, and adverse safety events.

“Though evidence on the long-term impact of inpatient EHRs on quality of care and patient safety is robust and largely positive, few studies have addressed the short term impact of EHR implementation or switching between vendors,” wrote Michael L Barnett, assistant professor of health policy and management, and colleagues. “Not surprisingly, many have raised concerns that EHR implementation or switching may adversely impact patient safety and quality in the weeks to months after transition. One hospital reported a more than doubling of mortality in the five months after activating a new computerized physician order entry module, a key component of EHR implementation.”

Researchers used the Medicare Provider Analysis and Review from 2010-12 with 28,235 patients and 26,453 admissions from 17 hospitals in the 90-day period before and after EHR implementation at the study’s hospitals.

In the time both before and after implementation the rate for mortality went from 6.74 percent to 7.15 percent, adverse safety event rates went from 10.5 to 11.4 events per 1,000 admissions and readmission rates went from 19.9 percent to 19.0 percent. These results meant the implementation of EHS's does not affect short-term inpatient mortality, adverse safety events or readmissions in the Medicare population.

“It appears that EHR implementation does not have negative clinical consequences. In our pre-specified subgroup analyses, we also did not find any evidence for negative clinical consequences by type of EHR implementation (new implementation versus switch of vendor) or risk of mortality,” wrote Barnett and colleagues. “This might reflect the clinical resiliency and advanced planning among hospitals undergoing EHR implementations. For example, hospitals may exert a large and costly amount of effort to compensate for the disruption of EHR transitions and to maintain the stable patient outcomes that we observed.”