Back to Search
Start Over
Leveraging EHRs to improve hospital performance: the role of management.
- Source :
-
The American journal of managed care [Am J Manag Care] 2014 Nov; Vol. 20 (11 Spec No. 17), pp. SP511-9. - Publication Year :
- 2014
-
Abstract
- Objectives: Recent studies fail to find a consistent relationship between adoption of electronic health records (EHRs) and improved hospital performance. We sought to examine whether the quality of hospital management modifies the association between EHR adoption and outcomes related to cost and quality.<br />Study Design: Retrospective study of a random sample of US acute care hospitals.<br />Methods: Management quality was assessed via phone interviews with clinical managers predominantly from cardiac units in a random sample of 325 hospitals using a validated scale of management practices in 4 areas: operations, performance monitoring, target setting, and talent management. American Hospital Association InformationTechnology Supplement data captured whether or not these hospitals had at least a basic EHR. Acute myocardial infarction (AMI) outcomes included risk-adjusted 30-day mortality, average length-of-stay, and average payment per discharge measured using MedPAR data. Ordinary least squares regressions assessed whether management quality modifies the relationship between EHR adoption and AMI outcomes.<br />Results: While we found no association between EHR adoption and our outcomes, management quality modified the relationship in the predicted direction. For length of stay, the coefficient on the interaction between EHR and management was -1.48 (P = .05) and for payment, it was -7786.74 (P = .014). We did not find strong evidence of effect modification for mortality (coefficient = -0.05; P = .37).<br />Conclusions: Coupled with ongoing policy efforts to achieve nationwide EHR adoption is a growing unease that our national investment may not result in better, more efficient care. Our study is among the first to offer empirical evidence that management quality may help explain why some hospitals see substantial gains from EHR adoption while others do not.
- Subjects :
- Acute Disease
Aged
Hospital Bed Capacity
Hospital Charges statistics & numerical data
Humans
Length of Stay statistics & numerical data
Medicare statistics & numerical data
Myocardial Infarction mortality
Myocardial Infarction therapy
Ownership
Quality Indicators, Health Care statistics & numerical data
Quality of Health Care organization & administration
Retrospective Studies
United States
Electronic Health Records statistics & numerical data
Hospital Administration statistics & numerical data
Quality of Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1936-2692
- Volume :
- 20
- Issue :
- 11 Spec No. 17
- Database :
- MEDLINE
- Journal :
- The American journal of managed care
- Publication Type :
- Academic Journal
- Accession number :
- 25811825