Do EHRs Impact Quality of Care in Ischemic Stroke Patients?

Using electronic health records (EHRs) was not associated with better clinical outcomes for ischemic stroke patients, according to a study published May 4 in the Journal of the American College of Cardiology.

The study, led by Karen E. Joynt, MD, MPH, from Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, used data from the Get With the Guidelines-Stroke program, and looked at 626,473 patients from 1,236 U.S. hospitals, between 2007 – 2010, to compare quality and outcome measures for ischemic stroke patients in hospitals with EHR systems to those without. Outcomes for the study included: a composite “all-or-none” quality performance measure, “which required that a patient received each of the achievement measures for which he or she was eligible;” length of stay greater than four days; discharge home; and in-hospital mortality.

The results of the study showed that there were no consistent relationships between the presence of an EHR system and improved quality of care or clinical outcomes in patients with ischemic stroke. However, patients admitted to hospitals with EHRs were slightly less likely to have a prolonged hospital stay.

The authors conclude that “although EHRs may be necessary for an increasingly high-tech, transparent health care system, as currently implemented, they do not appear to be sufficient to improve outcomes for this important disease.” They add that moving forward, “further work to ensure that [EHRs] are better integrated with care is critical … Our focus should turn to leveraging these tools to their fullest capabilities to improve quality of care and patient outcomes for stroke.”

In an accompanying editorial comment, John R. Windle, MD, FACC, and Thomas Windle, BA, note that the study “indicates that EHRs should be adaptable to different clinical environments... We need to promote user-centered design and not simply tweak EHRs designed around charge capture.” 

Keywords: Electronic Health Records, Hospital Mortality, Hospitalization, Hospitals, Length of Stay, Outcome Assessment (Health Care), Patient Discharge, Stroke

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