Title: Measuring the impact of certified electronic health record technology on cost, quality and safety outcomes

Authors: Joseph G. Conte; Anyi Chen; Terrence Cahill; Ning J. Zhang; Fortunato Battaglia; Kenneth R. Ong

Addresses: Staten Island PPS, 1 Edgewater Plaza – Suite 700, Staten Island, NY 10305, USA ' Staten Island PPS, 1 Edgewater Plaza – Suite 700, Staten Island, NY 10305, USA ' Department of Medical Sciences, Neurology and Psychiatry, Hackensack Meridian School of Medicine, Seton Hall University, 340 Kingsland Street – Building123, Room 4413, Nutley, NJ 07110, USA ' Department of Medical Sciences, Neurology and Psychiatry, Hackensack Meridian School of Medicine, Seton Hall University, 340 Kingsland Street – Building123, Room 4413, Nutley, NJ 07110, USA ' Department of Medical Sciences, Neurology and Psychiatry, Hackensack Meridian School of Medicine, Seton Hall University, 340 Kingsland Street – Building123, Room 4413, Nutley, NJ 07110, USA ' New York, USA

Abstract: Fewer than 9% of US hospitals had basic EHR systems as of 2008. The HITECH Act funded a multi-billion-dollar investment to close this gap requiring standards known as meaningful use (MU). The study was undertaken to assess whether this investment achieved the stated aims of MU; EHR adoption, lower cost and higher quality. The study is across-sectional, retrospective design; it employed two cohorts, MU vs. non-MU hospitals. Publicly reported, risk adjusted data from 4,221 hospitals (95%) on clinical, cost and safety metrics were analysed. The findings: EHR adoption by hospitals responded positively in response to incentives, rising from 8% to 55%. Quality outcomes showed 21,000 fewer deaths (p < 0.05) between the three clinical conditions (heart attack, heart failure, pneumonia). The HITECH Act had a positive return on investment with lower hospital cost per discharge of $327 (p < 0.05). The study results suggest hospitals with EHRs' that met MU standards demonstrate statistically significant mortality and cost improvement.

Keywords: meaningful use; HITECH Act; certified electronic health records; clinical outcomes; cost per discharge; EHR adoption; quality outcomes; healthcare information technology; HIT.

DOI: 10.1504/IJCMH.2019.104366

International Journal of Computational Medicine and Healthcare, 2019 Vol.1 No.1, pp.88 - 100

Published online: 06 Jan 2020 *