Study: EHR transitions don't hurt patient outcomes

Transitioning to an EHR does not hurt short-term inpatient outcomes, according to a new study of several Boston institutions in the BMJ.

The researchers, from Harvard, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and Massachusetts General Hospital hypothesized that a transition to EHRs or from one EHR to a different vendor would have a negative association with short term patient outcomes due to disruptions in clinical workflow. 

They reviewed 17 study hospitals that went live with a new EHR during 2011-2012 compared to 399 control hospitals in the same referral region, looking at the 90 day periods before and after the EHR implementation at the study hospitals. The characteristics of admissions for all of the hospitals were similar.

Contrary to the hypothesis, the researchers found no evidence between EHR implementation and short term mortality, readmission or adverse safety events. There was an unadjusted decrease in 30-day readmission rates from 19.9 percent to 19 percent but no significant change in outcome between the pre-implementation and post implementation periods. There was also no difference between hospitals implementing a new EHR versus one changing vendors.

“Despite well-documented usability issues with most EHRs and potential for electronically-enabled errors, even around the time of a switch when clinicians are least familiar with new systems, hospitals appear to have the clinical resilience to adapt and prevent worsening patient outcomes.

One interpretation of this is that even though learning a new EHR is a clinically painful experience, that does not appear to translate to significantly worse outcomes for patients in the short term,” head researcher Michael Barnett, assistant professor at Harvard and a primary care physician at Brigham and Women’s Hospital told FierceEHR.

“Our finding should be reassuring to hospitals and physicians who are considering or planning the implementation of EHRs,” the study concluded.

- here's the study

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