EHRs improve ICU care for certain quality measures

Electronic health records can help improve patient treatment in intensive care units (ICUs), but only to some extent, according to a new study in CHEST, the journal of the American College of Chest Physicians.

The researchers, from Mount Sinai School of Medicine, conducted a retrospective chart review to record quality indicators for all patients admitted to a surgical ICU in a tertiary facility from Jan. 1, 2009, through Dec. 31, 2013. They excluded the data from the year that the ICU transitioned to an EHR (2011). Quality indicators reviewed were length of stay, mortality, central line associated blood stream infection (CLABSI) rates, Clostridium difficile (C. diff.) colitis rates and readmission rates. They also reviewed the number of coded diagnoses.

The rate of CLABSI was 85 percent lower after implementation of the EHR, the researchers said, while mortality rates were 28 percent lower. However, there was no significant difference in the other quality indicators. 

Interestingly, there was a significant increase in the number of coded diagnoses, from 17.8 to 20.8.

"Considering the large investment into electronic health records and the high costs associated with ICU care, it's important to develop EHRs that improve ICU quality of care," the researchers concluded.

Other studies have pointed to mixed results regarding EHRs' effect on patient care. Their ability to harness large amounts of data can help clinicians predict patients at risk of readmission and catch other red flags. Moreover, clinical decision support tools and EHR embedded checklists are known to improve care. 

However, EHRs don't operate in a vacuum; simply using one does not mean that patient care in an ICU will automatically be improved, especially if the EHR is not specially designed to do so. It has also been pointed out that EHRs were developed more to improve billing, not patient care.

To learn more:
- here's the study abstract
- read the announcement