A new study from the Journal of the American Heart Association found there was not an association between a hospital’s degree of EHR implementation and improved quality of care and outcomes for heart failure patients.
The research examined participants in the Get with the Guidelines—Heart Failure program who were admitted to the hospital with heart failure in 2008. Get With the Guidelines is a national registry of hospitalized patients with heart failure.
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The hospitals involved had differing degrees of EHR implementation, categorized as “no EHR, partial EHR and full EHR.”
A total of 21,222 patients were eligible for the study. Approximately 1,484 individuals went to a hospital with no EHR; 13,473 were admitted to a hospital with a partial EHR; and 6,265 went to a hospital with a full EHR.
Many of the patients had comorbidities, such as hypertension, diabetes mellitus and hyperlipidemia. The majority of hospitals involved — 76 percent — were teaching hospitals.
Overall, the results show there isn’t an association between degrees of EHR implementation and better care quality, 30-day post-discharge death or readmission. The study only showed improvement in one area related to EHR use: beta blocker at discharge.
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“Our results suggest that EHR may not be sufficient to improve HF quality or related outcomes,” the study notes.
Despite these findings, the study points out that its analysis only included data from 2008, meaning it predates the passing of the HITECH Act. Since its passage in 2009, EHR adoption has increased.
“Our study questions assumptions about EHR implementation and improved quality of care and should draw increasing attention to EHR optimization in the current era of EHR technology,” it notes.
It also pinpoints a few noteworthy limitations. Researchers didn’t evaluate gains or losses in provider productivity and patient health status related to EHR use. Additionally, they didn’t have specific data on which types of EHRs hospitals used or if any clinical decision support tools were utilized.
The researchers conducted a substudy of 8,421 Medicare participants as well. Similarly, they found no association between EHR implementation status and 30-day mortality, readmission or a combined outcome.
Overall, they “do not contend, on the basis of our results, that EHR should not be adopted. Rather, [their] findings underscore the need for improved use of EHR or refinement of its clinical decision support and algorithm construction.”
Photo: BrianAJackson, Getty Images
