Implementing new or different electronic health records systems had negligible short-term effects on readmission or mortality rates across a 17-hospital sample, according to a study published in the BMJ.
The new or different information technology also had no statistically significant adverse impact on patient safety, they determined.
“Our findings should be reassuring to hospitals and physicians who are considering or planning the implementation of EHRs,” according to authors of the study, published online in the BMJ.
The researchers looked at Medicare claims data from more than 26,000 patient hospital admissions for 30-day readmission and 30-day mortality rates for a six-month period both before and after single-day, “big bang” new installations or upgrades of EHRs at 17 hospitals of 150 beds or more. They also looked at 11 of Medicare's group of patient safety indicators (PSI-90) which include pressure ulcers and central line infections.
They compared those results to outcomes from more than 276,000 patient admissions in a control group of 399 hospitals neighboring the study's 17 hospitals.
Using what researchers called a “difference-indifferences analysis” of the resulting data sets, they found “there was no change in 30-day mortality between pre-implementation and post-implementation periods.
The research team was led by Dr. Michael Barnett, assistant professor of Health Policy and Management at Harvard and primary care physician at Brigham and Women's Hospital.
There have been numerous reports, and even a few lawsuits over the purported patient safety implications of EHR systems, but the researchers said there was a paucity of information about the short-term impact of their installation.
“We hypothesized that implementation (EHRs) would have a negative association with short-term patient outcomes owing to disruption in clinical workflow,” the authors wrote, adding that their contrary conclusions “might reflect the clinical resiliency and advanced planning among hospitals undergoing EHR implementations."
For example, "hospitals may exert a large and costly amount of effort to compensate for the disruption of EHR transitions and to maintain the stable patient outcomes that we observed,” they opined.
