Transition to Electronic Records Causes Hospital Quality Challenges: Study

The findings of a new study by Rand Corporation suggest that while having electronic medical records available increases the quality of hospital care, the transition period to new electronic systems can be a rough road and may decrease the quality of care for some patients.  This may mean that patients at hospitals undergoing a conversion to electronic medical records face a potential increased risk of medical malpractice.

According to a study published online December 22 by the American Journal of Managed Care, researchers found that quality improvement for some types of serious medical care increased when hospitals had medical records electronically available, but decreased when the systems were newly adopted or highly advanced.

The Rand Corporation researchers conducted a national cohort study using data on hospital electronic health record (EHR) systems collected in 2003 and 2006, as well as publicly reported hospital quality data from 2004 and 2007. They found that there was a 2.6% improvement in the quality of hospital care for patients with heart failure when a basic EHR system was available. However, hospitals trying to adopt advanced EHR systems saw a nearly 1% decrease in quality of care for acute heart attack and a 3% decrease in care for heart failure patients.

Those hospitals who were in the process of upgrading their EHR from a basic system to a more advanced system saw a 1.2% decrease in the quality of care for heart attack patients, and a 2.8% decrease in quality care for heart failure patients.

The researchers said that part of the decreases could be accounted for as hospitals acclimated to new EHR systems. They found that hospitals whose electronic systems had been in place longer performed better. But they also noted that measuring the success of such systems was problematic, and that better means of assessing how well the record systems were performing needed to be developed.