The impact of electronic health record implementation and use on performance of the surgical care improvement project measures

Objective. To examine the impact of electronic health record (EHR) deployment on Surgical Care Improvement Project (SCIP) measures in a tertiary-care teaching hospital. Data Sources. SCIP Core Measure dataset from the CMS Hospital Inpatient Quality Reporting Program (March 2010 to February 2012). Study Design. One-group pre- and post-EHR logistic regression and difference-indifferences analyses. Principal Findings. Statistically significant short-term declines in scores were observed for the composite, postoperative removal of urinary catheter and post-cardiac surgery glucose control measures. A statistically insignificant improvement in scores for these measures was noted 3 months after EHR deployment. Conclusion. The transition to an EHR appears to be associated with a short-term decline in quality. Implementation strategies should be developed to preempt or minimize this initial decline. Key Words. Quality of care/patient safety (measurement), observational data/quasi-experiments, surgery
Several landmark reports have underscored the importance of health information technology (HIT) in promoting the quality of care (IOM 2001, 2012). The Health Information Technology for Economic and Clinical Health [...]