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EHR Adoption and Hospital Performance: Time‐Related Effects
Author(s) -
AdlerMilstein Julia,
Everson Jordan,
Lee ShoouYih D.
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12406
Subject(s) - medicine , incentive , meaningful use , family medicine , electronic health record , cohort , health care , economics , microeconomics , economic growth
Objective To assess whether, 5 years into the HITECH programs, national data reflect a consistent relationship between EHR adoption and hospital outcomes across three important dimensions of hospital performance. Data Sources/Study Setting Secondary data from the American Hospital Association and CMS (Hospital Compare and EHR Incentive Programs) for nonfederal, acute‐care hospitals (2009–2012). Study Design We examined the relationship between EHR adoption and three hospital outcomes (process adherence, patient satisfaction, efficiency) using ordinary least squares models with hospital fixed effects. Time‐related effects were assessed through comparing the impact of EHR adoption pre (2008/2009) versus post (2010/2011) meaningful use and by meaningful use attestation cohort (2011, 2012, 2013, Never). We used a continuous measure of hospital EHR adoption based on the proportion of electronic functions implemented. Data Collection/Extraction Methods We created a panel dataset with hospital‐year observations. Principal Findings Higher levels of EHR adoption were associated with better performance on process adherence (0.147; p < .001) and patient satisfaction (0.118; p < .001), but not efficiency (0.01; p = .78). For all three outcomes, there was a stronger, positive relationship between EHR adoption and performance in 2010/2011 compared to 2008/2009. We found mixed results based on meaningful use attestation cohort. Conclusions Performance gains associated with EHR adoption are apparent in more recent years. The large national investment in EHR s appears to be delivering more consistent benefits than indicated by earlier national studies.