{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:08:03Z","timestamp":1781237283855,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T00:00:00Z","timestamp":1519084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the impact of electronic health record (EHR) implementation on hospital finances.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We analyzed the impact of EHR implementation on bond ratings and net income from service to patients (NISP) at 32 hospitals that recently implemented a new EHR and a set of controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After implementing an EHR, 7 hospitals had a bond downgrade, 7 had a bond upgrade, and 18 had no changes. There was no difference in the likelihood of bond rating changes or in changes to NISP following EHR go-live when compared to control hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Most hospitals in our analysis saw no change in bond ratings following EHR go-live, with no significant differences observed between EHR implementation and control hospitals. There was also no apparent difference in NISP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Implementation of an EHR did not appear to have an impact on bond ratings at the hospitals in our analysis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocy007","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T04:06:23Z","timestamp":1516593983000},"page":"572-574","source":"Crossref","is-referenced-by-count":8,"title":["Changes in hospital bond ratings after the transition to a new electronic health record"],"prefix":"10.1093","volume":"25","author":[{"given":"Dustin","family":"McEvoy","sequence":"first","affiliation":[{"name":"Partners Healthcare, Information Systems, Somerville, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA"},{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean F","family":"Sittig","sequence":"additional","affiliation":[{"name":"School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skye","family":"Aaron","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ateev","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, MA, USA and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Wright","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Department of Medicine, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,2,20]]},"reference":[{"key":"2020110612372134900_ocy007-B1","first-page":"1","article-title":"Adoption of electronic health record systems among US non-federal acute care hospitals: 2008-2012","volume":"9","author":"Charles","year":"2013","journal-title":"ONC Data Brief."},{"key":"2020110612372134900_ocy007-B2","article-title":"Partners posts $108m operating loss, its largest","author":"McCluskey","year":"2016","journal-title":"The Boston Globe [serial on the Internet]"},{"key":"2020110612372134900_ocy007-B3","article-title":"MD Anderson runs up $102 million in losses","author":"Loeb","year":"2016","journal-title":"Houston Chronicle [serial on the Internet]"},{"key":"2020110612372134900_ocy007-B4","doi-asserted-by":"crossref","first-page":"i3835","DOI":"10.1136\/bmj.i3835","article-title":"Adverse inpatient outcomes during the transition to a new electronic health record system: observational study","volume":"354","author":"Barnett","year":"2016","journal-title":"BMJ"},{"key":"2020110612372134900_ocy007-B5","volume-title":"Moody\u2019s Investors Service, Inc., Moody\u2019s Analytics, Inc.","author":"Moody\u2019s Corporation"},{"key":"2020110612372134900_ocy007-B6","article-title":"Cost Reports. [updated October 17, 2017]","author":"US Centers for Medicare and Medicaid Services"},{"key":"2020110612372134900_ocy007-B7","volume-title":"Healthcare Cost Report Information System (HCRIS) Data","author":"Roth","year":"2004"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/25\/5\/572\/34150657\/ocy007.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/25\/5\/572\/34150657\/ocy007.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T17:49:16Z","timestamp":1604684956000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/25\/5\/572\/4881750"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,20]]},"references-count":7,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,2,20]]},"published-print":{"date-parts":[[2018,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocy007","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,5]]},"published":{"date-parts":[[2018,2,20]]}}}