Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes

Autor: DaJuanicia N Simon, Jonathan R. Enriquez, Laine Thomas, James A. de Lemos, John A. Spertus, Sandeep R Das, Paul S. Chan, Shailja V. Parikh, Tracy Y. Wang
Rok vydání: 2015
Předmět:
Male
Gerontology
medicine.medical_specialty
health care facilities
manpower
and services
Myocardial Infarction
Psychological intervention
Lower risk
Article
Electronic health record
health services administration
Odds Ratio
medicine
Electronic Health Records
Humans
Medication Errors
Registries
Myocardial infarction
Quality of care
health care economics and organizations
Aged
Quality Indicators
Health Care
Heparin
business.industry
Process Assessment
Health Care
Anticoagulants
Odds ratio
Middle Aged
medicine.disease
Quality Improvement
Hospitals
United States
Confidence interval
Logistic Models
Treatment Outcome
Health Care Surveys
Multivariate Analysis
Practice Guidelines as Topic
Emergency medicine
Female
Guideline Adherence
Drug Overdose
Cardiology and Cardiovascular Medicine
business
Delivery of Health Care
Major bleeding
Zdroj: Circulation: Cardiovascular Quality and Outcomes. 8:576-585
ISSN: 1941-7705
1941-7713
Popis: Background— In 2009, national legislation promoted wide-spread adoption of electronic health records (EHRs) across US hospitals; however, the association of EHR use with quality of care and outcomes after acute myocardial infarction (AMI) remains unclear. Methods and Results— Data on EHR use were collected from the American Hospital Association Annual Surveys (2007–2010) and data on AMI care and outcomes from the National Cardiovascular Data Registry Acute Coronary Treatment and Interventions Outcomes Network Registry-Get With The Guidelines. Comparisons were made between patients treated at hospitals with fully implemented EHR (n=43 527), partially implemented EHR (n=72 029), and no EHR (n=9270). Overall EHR use increased from 82.1% (183/223) hospitals in 2007 to 99.3% (275/277) hospitals in 2010. Patients treated at hospitals with fully implemented EHRs had fewer heparin overdosing errors (45.7% versus 72.8%; P Conclusions— EHR use has risen to high levels among hospitals in the National Cardiovascular Data Registry. EHR use was associated with less frequent heparin overdosing and modestly greater adherence to acute MI guideline-recommended therapies. In non–ST-segment–elevation MI, slightly lower adjusted risk of major bleeding and mortality were seen in hospitals implemented with full EHRs; however, in ST-segment–elevation MI, differences in outcomes were not seen.
Databáze: OpenAIRE
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