Benefits of EHRs

Improved Diagnostics & Patient Outcomes

When health care providers have access to complete and accurate information, patients receive better medical care. Electronic health records (EHRs) can improve the ability to diagnose diseases and reduce—even prevent—medical errors, improving patient outcomes.

EHRs can aid in diagnosis

With EHRs, providers can have reliable access to a patient's complete health information. This comprehensive picture can help providers diagnose patients' problems sooner.

EHRs can reduce errors, improve patient safety, and support better patient outcomes

How? EHRs don't just contain or transmit information; they "compute" it. That means that EHRs manipulate the information in ways that make a difference for patients. For example:

  • A qualified EHR not only keeps a record of a patient's medications or allergies, it also automatically checks for problems whenever a new medication is prescribed and alerts the clinician to potential conflicts.
  • Information gathered by a primary care provider and recorded in an EHR tells a clinician in the emergency department about a patient's life-threatening allergy, and emergency staff can adjust care appropriately, even if the patient is unconscious.
  • EHRs can expose potential safety problems when they occur, helping providers avoid more serious consequences for patients and leading to better patient outcomes.
  • EHRs can help providers quickly and systematically identify and correct operational problems. In a paper-based setting, identifying such problems is much more difficult, and correcting them can take years.

Risk Management and Liability Prevention: Study Findings

1

EHRs May Improve Risk Management By:

 

  • Providing clinical alerts and reminders
  • Improving aggregation, analysis, and communication of patient information
  • Making it easier to consider all aspects of a patient's condition
  • Supporting diagnostic and therapeutic decision making
  • Gathering all relevant information (lab results, etc.) in one place
  • Support for therapeutic decisions
  • Enabling evidence-based decisions at point of care
  • Preventing adverse events
  • Providing built-in safeguards against prescribing treatments that would result in adverse events
  • Enhancing research and monitoring for improvements in clinical quality

Certified EHRs May Help Providers Prevent Liability Actions By:

  • Demonstrating adherence to the best evidence-based practices
  • Producing complete, legible records readily available for the defense (reconstructing what actually happened during the point of care)
  • Disclosing evidence that suggests informed consent
  1. 1 Couch, James B. "CCHIT certified electronic health records may reduce malpractice risk," Physician Insurer. 2008.

EHRs can improve public health outcomes

EHRs can also have beneficial effects on the health of groups of patients.

Providers who have electronic health information about the entire population of patients they serve can look more meaningfully at the needs of patients who:

  • Suffer from a specific condition
  • Are eligible for specific preventive measures
  • Are currently taking specific medications

This EHR function helps providers identify and work with patients to manage specific risk factors or combinations of risk factors to improve patient outcomes.

For example, providers might wish to identify:

  • How many patients with hypertension have their blood pressure under control
  • How many patients with diabetes have their blood sugar measurements in the target range and have had appropriate screening tests

This EHR function also can detect patterns of potentially related adverse events and enable at-risk patients to be notified quickly.

Studies Show: Better Patient Outcomes With EHRs

Using EHR Prompts & Reminders To Improve Quality of Care

  • Reminders resulted in improved blood pressure control in older patients with hypertension. 1
  • A significantly greater proportion of patients achieved American Diabetes Association (ADA) guidelines for control of blood pressure, blood glucose levels, and low-density lipoprotein cholesterol (LDL, "bad cholesterol").
  • Reminders resulted in improved rates of recommended preventive eye, foot, and renal examinations or screenings.
  • Prompts increased mammography rates by 10%. 2

Using EHR Prompts & Reminders to Improve Quality of Patient Care 3

High Patient Satisfaction
  • 92% were happy their doctor used e-prescribing.
  • 90% reported rarely or only occasionally going to the pharmacy and having prescription not ready.
  • 76% reported it made obtaining medications easier.
  • 63% reported fewer medication errors.
High Provider Satisfaction
  • Reduced overall rate of after-hours clinic calls.
Using EHRs to Improve Diabetes Management 4

The Study

  • Physician-directed, multifaceted health IT system
  • 6,072 patients over 24-month period

Outcomes

  • Significant improvements in all diabetes indicators except for mean HbA1c (blood glucose levels)
    • Change from 32% to 56% at LDL goal
    • Change from 30% to 50% with BP <130/80 mgHg
    • Change from 47% to 50% with HbA1c <7%
  • High patient satisfaction
Using EHR Decision Support to Improve Asthma Care and Compliance 5

The Study

  • Cluster randomization of clinics
  • Intervention: Clinical decision support (CDS) embedded in EHR

Outcomes

  • 6% greater use of controller medications (preventive or maintenance medications to help prevent asthma symptoms from occurring)
  • 3% greater use of spirometry (a common office test used to diagnose asthma and other conditions that affect breathing)
  • 14% greater use of asthma care plan
  • Spirometry improved by 6% in suburban practices
Using EHRs to Increase Childhood Immunization Rates 6

The Study

  • 1–year study in an urban pediatric population
  • Intervention: clinical alerts for immunizations

Outcomes

  • Increased "captured" immunization opportunities
    • 78.2% to 90.3% for well visits
    • 11.3% to 32% at sick visits
  • Adjusted up-to-date immunization rates
    • 81.7% to 90.1% at 24 months
Using EHRs to Improve Documentation and Coding 7
  • Based on level of medical decision-making, ~50% of visits under-coded
  • Rural family practice implementing EHR + Practice Management (EPM) system
  • Increased case mix (type or mix of patients treated by a hospital or unit) by 10% over 2 years from 1.34 to 1.47
  • EHR documentation templates in multi-specialty clinic
    • Increased use of ICD code 99214 by 11%
    • Average billable gain of $26/patient
    • Increased revenue by >100K during the study period
  1. 1 Ciemins EL, Coon PJ, Fowles JB. "Beyond health information technology: Critical factors necessary for effective diabetes disease management", Journal of Diabetes Science and Technology. 3:3;2009.
  2. 2 Baron RJ. "Quality improvement with an electronic health record: achievable but not automatic", Annals of Internal Medicine. 147:8;2007.
  3. 3 Duffy L, et. al. "Effects of electronic prescribing on the clinical practice of a family medicine residency", Fam Med. 2010;42(5):358-63
  4. 4 Hunt JS et. al. The impact of a physician-directed health information technology system on diabetes outcomes in primary care: a pre-and post-implementation study. Informatics in Primary Care. 2009;17:165-74.
  5. 5 Bell LM, Grundmeier R, Localio R, Zorc J, et al. Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. Pediatrics. 125(4):e770-7, 2010 Apr.
  6. 6 Fiks AG, Grundmeir RW, Biggs LM, Locallo R, Alessandrini EA. "Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population", Pediatrics. 120(4):2007;707-14.
  7. 7 Holt J, Warsy A, Wright P. "Medical decision making: guide to improved CPT coding", Southern Medical Journal. 103(4):316-22, 2010 Apr. AHRQ Publication No: 09-0095 dated September 2009.