In February 2009, Congress enacted the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act, to promote the adoption and meaningful use of health information technology.
[Photo: A UNC researcher has found that hospitals across the U.S. have benefited over the last several years from some combination of 1) adopting electronic health records (EHR) functions that more consistently improve performance and 2) improvements in EHR technology and implementation. He also found modest support for the study’s hypothesis that organizational experience with EHRs may contribute to improved patient satisfaction and process adherence. Photo by Christiana Care/Flickr Creative Commons.]
Five years into the program, a UNC Gillings School of Global Public Health professor conducted a study of national data to determine whether the adoption and use of electronic health records (EHR) has had a consistent impact upon hospital outcomes in the areas of process adherence, patient satisfaction and efficiency.
Dr. Shoou-Yih Daniel Lee, professor and chair of the Gillings School’s Department of Health Policy and Management, is co-author of “EHR Adoption and Hospital Performance: Time-Related Effects,” published online Oct. 16 in the journal Health Services Research.
Dr. Lee and colleagues used secondary national data from the American Hospital Association and the Centers for Medicare and Medicaid Services for nonfederal, acute-care hospitals in 2009 to 2012, comparing the impact of EHR adoption before (2008-2009) and after (2010-2011) the institution of the HITECH Act.
They found that higher levels of EHR adoption were associated with better performance on process adherence and patient satisfaction, but not on efficiency. For all three outcomes, there was a stronger, positive relationship between EHR adoption and performance in 2010-2011, as compared with 2008-2009.
The authors concluded that hospitals across the U.S. have benefited over the last several years from some combination of 1) adopting EHR functions that more consistently improve performance, and 2) improvements in EHR technology and implementation. They also found modest support for their hypothesis that organizational experience with EHRs may contribute to improved patient satisfaction and process adherence. Taken together, the findings suggest that time-related effects appear to be important in driving high performance from EHRs in the three high-priority domains of hospital care.
“This is encouraging with respect to the payoff from the large national investment in EHRs,” the authors write, “and reflects the experience in other industries in which gains from information technology took many years to realize.”
The authors found “consistent and compelling” evidence of a relationship between EHR adoption and performance for the three key outcomes in the post-HITECH period. This, they say, suggests that the introduction of HITECH policies – along with other industry trends and individual hospital experience – jointly may have contributed to these results, providing justification for the large investment in EHRs and supporting the belief that these technologies are contributing to better hospital care.
Dr. Lee’s co-authors are Dr. Julia Adler-Milstein, of the University of Michigan at Ann Arbor’s School of Information and School of Public Health, and Mr. Jordan Everson, doctoral student in the Michigan School of Public Health’s department of health management and policy. Dr. Lee was at the University of Michigan School of Public Health at the time the study began.