title: Does adoption of electronic health records improve organizational performances of hospital surgical units? Results from the French e-SI (PREPS-SIPS) study.
abstract: Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the organizational performances of acute care hospital surgical units throughout France.
  
  
  
  This retrospective study was based on data derived from three national databases for year the 2012: IPAQSS (Indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. National data and methodological support were provided by the French Ministry of Health (DGOS) and the French National Authority for Health (HAS). Multivariate linear models were used to assess four organizational performance indicators: the occupancy rate of surgical inpatient beds, operating room utilization, the activity per surgeon, and the activity per both nurse anesthetist and anesthesiologist which were dependent variables. Several independent variables were taken into account, including the degree of EHR use.
  
  
  
  The models revealed a significant positive impact of EHR use on operating room utilization and bed occupancy rates for surgical inpatient units. No significant association was found between the activity per surgeon or the activity per nurse anesthetist and anesthesiologist with EHR use. All four organizational performance indicators were impacted by the type of hospital, the geographical region, and the severity of the pathologies.
  
  
  
  We were able to verify the purported potential benefits of EHR use on the organizational performances of surgical units in French hospitals.
authors.affiliation: Direction de la Recherche Clinique et de l'Innovation, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: morgane.plantier@lyon.unicancer.fr.
authors.forename: Morgane
authors.initials: M
authors.lastname: Plantier
authors.affiliation: GATE-LSE UMR-CNRS 5824, 93 Chemin des Mouilles, 69130 Ecully, France. Electronic address: havet@gate.cnrs.fr.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Havet
authors.affiliation: Direction du Système d'Information, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: thierry.durand@lyon.unicancer.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Durand
authors.affiliation: Groupe Hospitalier Mutualiste de Grenoble, 8 rue Dr Calmette, 38000 Grenoble, France. Electronic address: N.CAQUOT@ghm-grenoble.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Caquot
authors.affiliation: Direction de la Recherche Clinique et de l'Innovation, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: camille.amaz@lyon.unicancer.fr.
authors.forename: Camille
authors.initials: C
authors.lastname: Amaz
authors.affiliation: Direction de la Qualité, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: irene.philip@lyon.unicancer.fr.
authors.forename: Irène
authors.initials: I
authors.lastname: Philip
authors.affiliation: Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: pierre.biron@lyon.unicancer.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Biron
authors.affiliation: Direction de la Recherche Clinique et de l'Innovation, Centre de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon, France. Electronic address: lionel.perrier@lyon.unicancer.fr.
authors.forename: Lionel
authors.initials: L
authors.lastname: Perrier
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005602:France; D006801:Humans; D008490:Medical Informatics / Q000458:organization & administration*; D015279:Organizational Culture; D010348:Patient Care Team; D012189:Retrospective Studies; D013503:Surgery Department, Hospital
keywords: Econometric; Electronic health record; Hospital performance