@Article{info:doi/10.2196/23961,
author="Beauvais, Bradley
and Kruse, Clemens Scott
and Fulton, Lawrence
and Shanmugam, Ramalingam
and Ramamonjiarivelo, Zo
and Brooks, Matthew",
title="Association of Electronic Health Record Vendors With Hospital Financial and Quality Performance: Retrospective Data Analysis",
journal="J Med Internet Res",
year="2021",
month="Apr",
day="14",
volume="23",
number="4",
pages="e23961",
keywords="electronic health records; medical informatics; hospitals; delivery of health care; financial management; quality of health care; treatment outcome",
abstract="Background: Electronic health records (EHRs) are a central feature of care delivery in acute care hospitals; however, the financial and quality outcomes associated with system performance remain unclear. Objective: In this study, we aimed to evaluate the association between the top 3 EHR vendors and measures of hospital financial and quality performance. Methods: This study evaluated 2667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considered their performance with regard to net income, Hospital Value--Based Purchasing Total Performance Score (TPS), and the unweighted subdomains of efficiency and cost reduction; clinical care; patient- and caregiver-centered experience; and patient safety. We hypothesized that there would be a difference among the 3 vendors for each measure. Results: None of the EHR systems were associated with a statistically significant financial relationship in our study. Epic was positively associated with TPS outcomes (R2=23.6{\%}; $\beta$=.0159, SE 0.0079; P=.04) and higher patient perceptions of quality (R2=29.3{\%}; $\beta$=.0292, SE 0.0099; P=.003) but was negatively associated with patient safety quality scores (R2=24.3{\%}; $\beta$=−.0221, SE 0.0102; P=.03). Cerner and Epic were positively associated with improved efficiency (R2=31.9{\%}; Cerner: $\beta$=.0330, SE 0.0135, P=.01; Epic: $\beta$=.0465, SE 0.0133, P<.001). Finally, all 3 vendors were associated with positive performance in the clinical care domain (Epic: $\beta$=.0388, SE 0.0122, P=.002; Cerner: $\beta$=.0283, SE 0.0124, P=.02; Meditech: $\beta$=.0273, SE 0.0123, P=.03) but with low explanatory power (R2=4.2{\%}). Conclusions: The results of this study provide evidence of a difference in clinical outcome performance among the top 3 EHR vendors and may serve as supportive evidence for health care leaders to target future capital investments to improve health care delivery. ",
issn="1438-8871",
doi="10.2196/23961",
url="https://www.jmir.org/2021/4/e23961",
url="https://doi.org/10.2196/23961",
url="http://www.ncbi.nlm.nih.gov/pubmed/33851924"
}