EHRs may not improve care quality Ischemic stroke patients

Electronic health records may not bring any added benefit to when it comes to treating Ischemic stroke patients, according to a new study in the Journal of the American College of Cardiology.

The researchers reviewed 626,473 patients at 1,236 hospitals using the "Get with the Guidelines-Stroke" tool from 2007-2010. While 511 of the hospitals were using EHRs, the systems were not associated with higher quality care, more patients discharged home or lower in-hospital mortality rates. Patients in hospitals using EHRs did have a slightly lower risk of prolonged hospital stays.

"EHRs do not appear to be sufficient, at least as currently implemented, to improve overall quality of care or outcomes for this important disease state," Karen E. Joynt, lead study author and cardiologist at Brigham and Women's Hospital and Harvard Medical School in Boston, said in an announcement.

The researchers acknowledged, among other things, that since all of the hospitals studied were using specific stroke guidelines, that might have diluted the effect of EHR tools. They apparently did not address the fact that their most recent data is already five years old, which may not reflect current patient outcomes or improvements in EHRs.

In a related editorial, John Windle, M.D., professor and chief of cardiology at the University of Nebraska Medical Center, stated that EHRs were not meeting the government's "triple aim" of improving efficiency, improving patient care and improving population health. He noted that the Get with the Guidelines tool appeared to be working but that the EHRs as currently configured and used did not add any benefit.

"An EHR's first priority must be support of clinical care, not documentation for billing and reimbursement that adds a burden translatable into neither value, nor patient health or safety." Windle said. "The work by Joynt et al. is a wake-up call that we should heed."

Many stakeholders have expressed concern that EHRs were not delivering improved care as promised and as currently designed don't support clinicians. As care delivery evolves and moves to different payment models, EHRs may also fail to meet those needs.       

To learn more:
- check out the study
- read Windle's editorial
- here's the announcement

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