Hospitals that use advanced electronic medical records are more likely to see improvements in clinical quality, operational management, and administrative tasks.
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Hospitals that deploy advanced electronic medical records (EMRs) report that they achieve a broad range of benefits from their e-record systems, including improvements in clinical quality, patient safety, and operational efficiencies. The survey, a joint effort from HIMSS Analytics and the research firm The Advisory Board Company, also suggests that the federal government’s investment in EMRs has been worthwhile.
EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals, which relied on responses from 33 CIOs representing approximately 180 hospitals or hospital systems, also showed that hospitals with advanced EMRs are much more likely to implement strategies that explicitly target clinical objectives such as adverse drug event (ADE) reduction and other patient safety improvements.
"We are starting to see from IT executives a belief that IT is going to improve quality and effectiveness, and I think we see some real results to that end here," Jennifer Horowitz, HIMSS Analytics’ senior director, research, told InformationWeek Healthcare. "Hopefully as organizations continue to roll out more sophisticated EMR environments, they will continue to demonstrate benefits like this."
In his assessment, Douglas Thompson, senior research director at The Advisory Board Company, said during an InformationWeek interview that many hospitals don’t use EMRs to target and track data that show specific quality and safety improvements and therefore don’t know how valuable their EMR system is.
"It’s surprisingly and unfortunately common that hospitals don’t do that kind of work, and so they do have, in essence, dead systems as far as their actual results. That’s one of the big issues with EMRs today," Thompson said.
To help answer the question of whether the federal investment in EMRs is money well spent, HIMSS Analytics looked at hospitals that have achieved the criteria for Stage 6 and 7 of the EMR Adoption Model (EMRAM). At Stage 6, hospitals have implemented a comprehensive physician documentation and charting system for at least one patient care service area. The hospital also has a clinical decision support system and a radiology picture archiving and communication system (PACS) platform that allows physicians to access all digital and film-based images via the Intranet or other secure network.
A Stage 7 hospital is truly paperless, capable of sharing clinical information via electronic transactions or exchange of electronic records with all entities within a regional health network, including other hospitals, ambulatory clinics, sub-acute environments, employers, payers, and patients. Hospitals that achieve Stage 7 also use data warehousing and mining techniques to capture and analyze care data for performance improvement and advancing clinical decision support protocols. According to HIMSS Analytics, capabilities for hospitals that are at EMRAM stages 6 and 7 are similar to those defined for Stages 2 and 3 of Meaningful Use, respectively.
Among the key findings of the study are:
-- Hospitals with advanced EMRs target specific clinical objectives. More than half of respondents targeted improvements in quality measures for venous thromboembolism (VTE) (73%), stroke (70%), congestive heart failure (CHF) (64%), pneumonia (61%), acute myocardial infarction (AMI) (55%), and surgical (52%) patients. The vast majority of respondents also targeted their EMRs to reduce adverse drug event (ADE) (94%) and fulfill other safety indicators (91%).
-- Hospitals with advanced EMRs report achieving a broad range of benefits from their EMRs. All respondent hospitals have realized and documented at least one core measure benefit and one safety measure benefit from implementing their EMR. More than three-quarters (79%) of the respondent hospitals reported multiple core measure and/or safety benefits. The most commonly reported benefits were ADE reduction (73%), improvements in other patient safety indicators (58%), and improvements in VTE (55%) and CHF (48%) metrics.
In the area of safety measures, hospitals that targeted specific improvements were also much more likely to report achieving those improvements, with the sole exception being ADE reductions. Over three-quarters (77%) of the hospitals that targeted ADE reductions reported they had achieved some reductions, as did both of the two hospitals that did not target ADE reductions.
The survey included hospitals that ranged in size from a minimum of 25 beds to a maximum of nearly 900. The report also noted that nearly half of the hospitals (48%) are general medical/surgical facilities and another third are academic medical centers. The remaining hospitals include three pediatric facilities, two long-term acute care facilities, and a single critical access hospital.
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