Description

Portfolio Project

Abstract

Health information technology supports the collection, aggregation and dissemination of

the health data. Electronic Health Records, a specific instance of this technology, enables the

sharing of health information between points of care. These tools are electronic compilations of a

patient’s health and medication history, provider visits, treatment pans and diagnostic

information, such as lab and radiology results. The use of health IT and health information

exchange can improve the quality of patient care, empower patients by supporting open

communication with providers, increase patient safety and save money for the system. In this

health care report, we study how the usage of electronic health record systems have impacted

quality of care, physician productivity, and hospital efficiency. Using research data, we show that

usage of electronic health record systems such as clinical decision support (CDS) is associated

with improved quality indicators. We show a positive correlation between the degree of

electronic health record (EHR) use and delegation of EHR tasks on clinician productivity.

Finally, we show that health information technology (HIT) adoption and hospital-physician

integration hospital positively impacts hospital efficiency.

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Portfolio Project

Introduction:

Data for this research study on electronic health records systems comes from the National

Hospital Medical Care Surveys, Athena health practice management system and EHR task logs,

American Hospital Association's (AHA) annual survey, the AHA IT survey, CMS Case Mix

Index, and the US Census Bureau's small area income and poverty estimates. The data covers

several periods from 1998 through 2014.

Prior research also supports the conclusion that the use of Electronic Health Records

systems positively impacts Health Care delivery. The research survey of databases consisting of

900 million outpatient primary care visits to clinics with EHRs from 2006-2009 show that the

presence of clinical decision support (CDS) was associated with improved blood pressure control

and increased number of visits not related to adverse drug events. The use of CDS was

associated with improvement in several quality indicators (Hsiao & Hing, 2012).

The data also shows that increased use of Electronic Health Records was associated with

increased productivity units for large hospitals and clinics where automation brought efficiency

to the operations. Greater EHR use and greater EHR task delegation were independently

associated with higher levels of productivity (Poissant et al, 2005).

EHR adoption and hospital-physician integration, individually, have statistically

significant positive impacts on hospital efficiency which shows that EHR adoption and hospital-

physician integration are key parts of improving hospital efficiency (Lammers, 2013).

Significance of the study:

The significance of this research study is that it shows that an EHR-based clinical

decision support system leads to modest but significant improvements in patient care. This

finding incentivizes physicians to learn EHR system use and transfer what they learned from

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Portfolio Project

using the clinical decision support system with some patients to the care of other patients. It also

enables health care administrators to recognize that EHR infrastructure will become ubiquitous

for personalization of medical care in the coming era of genomic medicine. EHR-embedded

clinical decision support may become an essential tool needed to systematically process complex

risk prediction data and then accurately identify appropriate clinical goals and high-priority

treatment options for each patient at each clinical encounter efficiency (Chaudhary, Wang & Wu,

2006). In summary, we aim to show that electronic health record systems (EHR) positively

impacts quality of care, physician productivity, and hospital.

Objectives are:

1. To determine whether usage of electronic health record systems such as clinical

decision support (CDS) is associated with improved quality indicators.

2. To examine the impact of the degree of electronic health record (EHR) use and

delegation of EHR tasks on clinician productivity.

3. To determine the impact of health information technology (HIT) adoption and

hospital-physician integration on hospital efficiency.