Meaningful Use alters hospitals' EHR implementation sequencing

Hospitals tend to use a common sequence when adopting electronic health records functions, but Meaningful Use is changing that sequence, which could impact patient care, according to a new study in the Journal of the American Medical Informatics Association.

The study, conducted by researchers from the University of Michigan, examined the order in which 2,794 general acute care non-federal hospitals adopted different EHR functions, the first such national study of this kind. They found a general consistency across the board, with patient demographics and ancillary results functions adopted first, and physician notes, clinical reminders and guidelines adopted last.  

The researchers also found a "stronger homogeneity" among small, rural and non-teaching hospitals, which may be due to greater reliance on vendors and less variation in the types of care those hospitals deliver.

Most importantly, the study found that the Meaningful Use program is causing hospitals to alter the order in which they implement EHR functions.

"[M]any functions emphasized in Stage 1 Meaningful Use are typically adopted later in the sequence, in particular clinical guidelines and medication CPOE, suggesting that Meaningful Use may change the planned prioritization of EHR function adoption," researchers Julia Adler-Milstein, Jordan Everson and Shoou-Yih D Lee said. "These findings will help policymakers anticipate the impact of meaningful use, and how it may vary for different types of hospitals."

The researchers also stressed the importance of assessing "the impact of such re-ordering on patient care and the cost of EHR adoption in hospitals."

Other studies have found EHRs are changing many operational aspects of healthcare, such as the transmission of lab results and what parts of a note doctors are more likely to read. It is not yet known how these changes may affect patient care.

To learn more:
- here's the study abstract

Alert fatigue, overrides remain safety threat
Docs give short shrift to vital signs, lab results in electronic notes
CDC: Use lab professionals to improve EHR safety
ONC: Clinicians must recognize when EHRs create unsafe conditions