Do Hospitals With Electronic Medical Records (EMRs) Provide Higher Quality Care?: An Examination of Three Clinical Conditions
This study investigates how hospital electronic medical record (EMR) use influences quality performance. Data include nonfederal acute care hospitals in the United States. Sources of the data include the American Hospital Association, Hospital Quality Alliance, the Healthcare Information and Management Systems Society, and the Centers for Medicare and Medicaid Services case-mix index sets. The authors use a retrospective cross-sectional format with linear regression to assess the relationship between hospital EMR use and quality performance. Quality performance is measured using 10 process indicators related to 3 clinical conditions: acute myocardial infarction, congestive heart failure, and pneumonia. The authors also use a propensity score adjustment to control for possible selection bias. After this adjustment, the authors identify a positive significant relationship between EMR use and 4 of the 10 quality indicators. They conclude that there is limited evidence of the relationship between hospital EMR use and quality.
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- "Electronic medical records are thought to be the panacea for dealing with these issues. However, they have not been associated with higher quality care (Kazley & Ozcan, 2008). EHR projects are typically large-scale projects that are both organizationally and culturally transforming (Smaltz & Berner, 2007). "
- "Hospitals with HIT may achieve this by improving communication, making knowledge more readily accessible, performing checks in real time, assisting with monitoring, and providing decision support (Bates and Gawande, 2003). In particular , researchers have noted that electronic health records (EHRs) are an especially promising form of HIT (Furukawa et al., 2010; Kazley and Ozcan, 2008). EHR generally consist of numerous possible combinations of HIT applications that may range from a grouping of basic functionalities to a more comprehensive set of functions. "
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ABSTRACT: Electronic health records (EHR) are a promising form of health information technology that could help US hospitals improve on their quality of care and costs. During the study period explored (2005-2009), high expectations for EHR diffused across institutional stakeholders in the healthcare environment, which may have pressured hospitals to have EHR capabilities even in the presence of weak technical rationale for the technology. Using an extensive set of organizational theory-specific predictors, this study explored whether five factors - cause, constituents, content, context, and control - that reflect the nature of institutional pressures for EHR capabilities motivated hospitals to comply with these pressures. Using information from several national data bases, an ordered probit regression model was estimated. The resulting predicted probabilities of EHR capabilities from the empirical model's estimates were used to test the study's five hypotheses, of which three were supported. When the underlying cause, dependence on constituents, or influence of control were high and potential countervailing forces were low, hospitals were more likely to employ strategic responses that were compliant with the institutional pressures for EHR capabilities. In light of these pressures, hospitals may have acquiesced, by having comprehensive EHR capabilities, or compromised, by having intermediate EHR capabilities, in order to maintain legitimacy in their environment. The study underscores the importance of our assessment for theory and policy development, and provides suggestions for future research.
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- "Another area non-directly related to clinical skills that we are interested in is education and information in e-health for general practitioners. Services and systems proposed by ehealth including EHR(Electronic health records), e-prescribing, and Healthcare Information Systems, would allow the health care provider to be better informed, and facilitate remote medical collaboration and resource management, which helps to deliver higher quality care  . "
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ABSTRACT: Most educational games and training applications for health care professionals have been developed as simulation tools dedicated to the teaching of medical knowledge in a particular area. Non-clinical skills such as communication skills or knowledge about e-Health are insufficiently focused by such tools. A serious game with consistent educational objectives offers to the learner many possibilities to acquire multiple competences in a fun and engaging learning process. This paper presents a serious game composed with extensible educational modules that concentrate on providing high-quality health care knowledge. It is designed to respect the balance between serious and fun in both educational and game elements. The proposed architecture allows the learning objective to be clearly defined and facilitate the collaborations of actors involved in the development. A prototype of the communication skills module is presented as an example of a module design.
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