Researchers from the business school at Arizona State University, Tempe, say their work suggests electronic health-record systems in hospitals increase hospital costs, nurse staffing levels and the incidence of complications, but lower mortality rates for some conditions, according to a published report.
As a threatened nursing shortage looms, the ASU research team chose to test the assumption that health information technology might increase nurse productivity by improving workflow.
Financial and nurse-sensitive patient outcomes data on 326 hospitals used in the study came from the California Office of Statewide Health Planning and Development. HIMSS Analytics, the market research arm of the Healthcare Information and Management Systems Society, provided information about hospital IT systems availability and contract dates. Researchers assumed implementation began, on average, one year after the contract date.
According to their 22-page article, “Electronic Medical Records, Nurse Staff and Nurse-Sensitive Patient Outcomes: Evidence from California Hospitals, 1998-2007,” published in the journal Health Services Research, the three-man team from the W. P. Carey School of Business at ASU found IT implementations were associated with 6% to 10% higher cost per discharge in medical-surgical acute-care units. They also found relatively lower intensive IT implementations, at Stage 2 on the HIMSS Analytics adoption model, were coincident with 15% to 26% higher registered nurse hours by per day and reduced licensed vocational nurse cost by 2% to 4%. Meanwhile, higher, Stage 3 implementations were associated with 3% to 4% lower rates for in-hospital mortality for certain conditions, according to the report.