title: Assessing the impact of electronic health records as an enabler of hospital quality and patient satisfaction.
abstract: OBJECTIVE
  To assess the impact of using an advanced electronic health record (EHR) on hospital quality and patient satisfaction.
  
  
  METHODS
  This retrospective, cross-sectional analysis was conducted in 2012 to evaluate the association between advanced EHR use (Healthcare Information Management Systems Society [HIMSS] Stage 6 or 7 as of December 2012) and estimated process and experience of care scores for hospitals under the Medicare Hospital Value-Based Purchasing Program, using data from the American Hospital Association for 2008 to 2010. Generalized linear regression models were fit to test the association between advanced EHR use with process of care and experience of care, controlling for hospital characteristics. In a second analysis, the models included variables to account for HIMSS stage of advanced EHR use.
  
  
  RESULTS
  The study included 2,988 hospitals, with 248 (8.3%) classified as advanced EHR users (HIMSS Stage 6 or 7). After controlling for hospital characteristics, advanced EHR use was associated with a 4.2-point-higher process of care score (P < .001). Hospitals with Stage 7 EHRs had 11.7 points higher process of care scores, but Stage 6 users had scores that were not substantially different from those of nonadvanced users. There was no significant difference in estimated experience of care scores by level of advanced EHR use.
  
  
  CONCLUSIONS
  This study evaluated the effectiveness of the U.S. federal government's investment in hospital information technology infrastructure. Results suggest that the most advanced EHRs have the greatest payoff in improving clinical process of care scores, without detrimentally impacting the patient experience.
authors: Mr. Jarvis is administrative fellow, NorthShore University HealthSystem, Evanston, Illinois. Dr. Johnson is associate chair of research and education and associate professor, Department of Health Systems Management, and director, Rush Center for the Advancement of Healthcare Value, Rush University, Chicago, Illinois. Mr. Butler is president and chief operating officer, Rush University Medical Center, and chairman and associate professor, Department of Health Systems Management, Rush University, Chicago, Illinois. Ms. O'Shaughnessy is adjunct faculty, Department of Health Systems Management, Rush University, Chicago, Illinois, and project manager, Quality Operations, University HealthSystem Consortium, Chicago, Illinois. Mr. Fullam is senior director of marketing research in strategic planning, marketing, and program development and senior director of patient relations in performance improvement and clinical effectiveness, Rush University Medical Center, and assistant professor, Department of Health Systems Management, Rush University, Chicago, Illinois. Mr. Tran is senior vice president and chief information officer, Rush University Medical Center, and instructor, Department of Health Systems Management, Rush University, Chicago, Illinois. Ms. Gupta is associate vice president of performance improvement and clinical effectiveness, Rush University Medical Center, and adjunct faculty, Department of Health Systems Management, Rush University, Chicago, Illinois.
authors: Benjamin
authors: B
authors: Jarvis
authors: Tricia
authors: T
authors: Johnson
authors: Peter
authors: P
authors: Butler
authors: Kathryn
authors: K
authors: O'Shaughnessy
authors: Francis
authors: F
authors: Fullam
authors: Lac
authors: L
authors: Tran
authors: Richa
authors: R
authors: Gupta
mesh_terms: D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D006761:Hospitals; D006801:Humans; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care; D011787:Quality of Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States