Open AccessAssociation of Electronic Health Record Use With Quality of Care and Outcomes in Heart Failure: An Analysis of Get With The Guidelines—Heart Failure
Author(s) -
Selvaraj Senthil,
Fonarow Gregg C.,
Sheng Shubin,
Matsouaka Roland A.,
DeVore Adam D.,
Heidenreich Paul A.,
Hernandez Adrian F.,
Yancy Clyde W.,
Bhatt Deepak L.
Publication year - 2018
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.117.008158
Subject(s) - medicine , logistic regression , cohort , heart failure , electronic health record , emergency medicine , cohort study , ejection fraction , health care , economics , economic growth
Background Adoption of electronic health record ( EHR ) systems has increased significantly across the nation. Whether EHR use has translated into improved quality of care and outcomes in heart failure ( HF ) is not well studied. Methods and Results We examined participants from the Get With The Guidelines— HF registry who were admitted with HF in 2008 (N=21 222), using various degrees of EHR implementation (no EHR , partial EHR , and full EHR ). We performed multivariable logistic regression to determine the relation between EHR status and several in‐hospital quality metrics and outcomes. In a substudy of Medicare participants (N=8421), we assessed the relation between EHR status and rates of 30‐day mortality, readmission, and a composite outcome. In the cohort, the mean age was 71±15 years, 49% were women, and 64% were white. The mean ejection fraction was 39±17%. Participants were admitted to hospitals with no EHR (N=1484), partial EHR (N=13 473), and full EHR (N=6265). There was no association between EHR status and several quality metrics (aside from β blocker at discharge) or in‐hospital outcomes on multivariable adjusted logistic regression ( P >0.05 for all comparisons). In the Medicare cohort, there was no association between EHR status and 30‐day mortality, readmission, or the combined outcome. Conclusions In a large registry of hospitalized patients with HF, there was no association between degrees of EHR implementation and several quality metrics and 30‐day postdischarge death or readmission. Our results suggest that EHR may not be sufficient to improve HF quality or related outcomes.