Electronic medical record (EMR) systems are costly for hospitals to implement and maintain, and the effects of EMR on the cost of care for inpatient pediatrics remain unknown. Our objective was to determine whether delivering care with advanced-stage EMR was associated with a decreased cost per case in a national sample of hospitalized children.
The Healthcare Cost and Utilization Project Kids Inpatient Dataset 2009 identified pediatric discharges. The Healthcare Information and Management Systems Society 2009 database identified hospitals' EMR use. EMR was classified into 3 stages, with advanced-stage 3 EMR including automation of ancillary services, automation of nursing workflow, computerized provider order entry, and clinical decision support. Multivariable linear regression was used to determine the independent effect of advanced-stage EMR on cost per case. Propensity score adjustment was included to control for nonrandom assignment of EMR use.
This analysis included 4,605,454 weighted discharges. EMR use by hospitals that care for children was common: 24% for stage 1, 23% stage 2, and 32% advanced stage 3. The multivariable model demonstrated that advanced stage EMR was associated with an average 7% greater cost per case ($146 per discharge).
The care of children across the United States with EMRs may create a safer health care system but is not associated with inpatient cost savings. In fact our primary analysis shows a 7% additional cost per case. This finding is contrary to predicted savings and may represent an added barrier in the adoption of EMR for inpatient pediatrics.
"EMR has been shown to reduce cost for hospitals but surprisingly, the cost per case increases for care of children (Teufel, et al. 2012). Another study showed no apparent cost saving for the patient but only for the institution (Xue, et al. 2012). "
[Show abstract][Hide abstract] ABSTRACT: This research aims to determine the benefits and challenges which hinder the adoption of electronic medical record (EMR) and how the challenges can be overcome. The identification of these will be crucial for increasing adoption rates to better healthcare quality. Unless identified clearly, the challenges will be a barrier for any hospital aiming to adopt EMR. For the purpose of this study, data was obtained from Healthcare authorities, hospital administrator and healthcare solution provider via interviews in the U.A.E. The data collected was analyzed to identify benefits, challenges and proposed solutions. Trends were identified and discussed. It was discovered that major barriers are cost, systems integration, data entry and change management. The benefits are numerous and include improvements in efficiency, safety, quality, response times and management operations. The solutions to challenges include financial support from government, training and education of staff.The data substantiate that electronic medical records are essential for the provision of quality in healthcare.
Proceedings of the Second International Conference on Emerging Research Paradigms in Business and Social Sciences, Dubai; 11/2013
[Show abstract][Hide abstract] ABSTRACT: The objective was to assess whether rates of preventive counseling delivered at well child visits (WCVs) differ for practices with basic, fully functional, or no electronic health record (EHR). Cross-sectional analyses of WCVs included in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey Electronic Medical Records Supplement, 2007-2010 were performed. Practices with fully functional EHRs documented delivery of 34% more counseling topics than those without an EHR. WCVs with a fully functional EHR lasted 3.5 more minutes than those with a basic EHR. Overall, for each additional 10 min, 12% more topics were covered, regardless of EHR functionality. Further studies should assess the impact of such systems on the quality of patient care during preventive care visits and on health outcomes.
Journal of the American Medical Informatics Association 09/2013; 21(E1). DOI:10.1136/amiajnl-2013-002260 · 3.50 Impact Factor
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