{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T01:09:54Z","timestamp":1775956194692,"version":"3.50.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,6,24]],"date-time":"2019-06-24T00:00:00Z","timestamp":1561334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Research Evaluation and Allocation Committee"},{"DOI":"10.13039\/100008069","name":"University of California, San Francisco","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008069","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical and Translational Sciences Institute"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Electronic health records (EHRs) were expected to yield numerous benefits. However, early studies found mixed evidence of this. We sought to determine whether widespread adoption of modern EHRs in the US has improved clinical care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We studied hospitals reporting performance measures from 2008\u20132015 in the Centers for Medicare and Medicaid Services Hospital Compare database that also reported having an EHR in the American Hospital Association 2015 IT supplement. Using interrupted time-series analysis, we examined the association of EHR implementation, EHR vendor, and Meaningful Use status with 11 process measures and 30-day hospital readmission and mortality rates for heart failure, pneumonia, and acute myocardial infarction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1246 hospitals contributed 8222 hospital-years. Compared to hospitals without EHRs, hospitals with EHRs had significant improvements over time on 5 of 11 process measures. There were no substantial differences in readmission or mortality rates. Hospitals with CPSI EHR systems performed worse on several process and outcome measures. Otherwise, we found no substantial improvements in process measures or condition-specific outcomes by duration of EHR use, EHR vendor, or a hospital\u2019s Meaningful Use Stage 1 or Stage 2 status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this national study of hospitals with modern EHRs, EHR use was associated with better process of care measure performance but did not improve condition-specific readmission or mortality rates regardless of duration of EHR use, vendor choice, or Meaningful Use status. Further research is required to understand why EHRs have yet to improve standard outcome measures and how to better realize the potential benefits of EHR systems.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocz092","type":"journal-article","created":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T11:08:43Z","timestamp":1558177723000},"page":"999-1009","source":"Crossref","is-referenced-by-count":29,"title":["Electronic health records systems and hospital clinical performance: a study of nationwide hospital data"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5782-7437","authenticated-orcid":false,"given":"Neal","family":"Yuan","sequence":"first","affiliation":[{"name":"Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Adams","family":"Dudley","sequence":"additional","affiliation":[{"name":"Center for Healthcare Value, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W John","family":"Boscardin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics and Division of Geriatrics, University of California at San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace A","family":"Lin","sequence":"additional","affiliation":[{"name":"Center for Healthcare Value, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA"},{"name":"Division of General Internal Medicine, University of California, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"2020110613072654100_ocz092-B1","volume-title":"To Err Is Human: Building a Safer Health System","author":"Institute of Medicine","year":"2000"},{"key":"2020110613072654100_ocz092-B2","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine","year":"2001"},{"key":"2020110613072654100_ocz092-B3","volume-title":"Key Capabilities of Electronic Health Record","author":"Institute of Medicine","year":"2003"},{"key":"2020110613072654100_ocz092-B4","author":"The Office of the National Coordinator for Health Information Technology"},{"issue":"5","key":"2020110613072654100_ocz092-B5","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1056\/NEJMp0912825","article-title":"Launching HITECH","volume":"362","author":"Blumenthal","year":"2010","journal-title":"N Engl J Med"},{"issue":"6","key":"2020110613072654100_ocz092-B6","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1377\/hlthaff.2010.0503","article-title":"Health information technology: laying the infrastructure for national health reform","volume":"29","author":"Buntin","year":"2010","journal-title":"Health Aff (Millwood)"},{"issue":"10","key":"2020110613072654100_ocz092-B7","doi-asserted-by":"crossref","first-page":"742","DOI":"10.7326\/0003-4819-144-10-200605160-00125","article-title":"Systematic review: impact of health information technology on quality, efficiency, and costs of medical care","volume":"144","author":"Chaudhry","year":"2006","journal-title":"Ann Intern Med"},{"issue":"12","key":"2020110613072654100_ocz092-B8","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1001\/archinte.163.12.1409","article-title":"Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review","volume":"163","author":"Kaushal","year":"2003","journal-title":"Arch Intern Med"},{"issue":"2","key":"2020110613072654100_ocz092-B9","doi-asserted-by":"crossref","first-page":"e41.","DOI":"10.2196\/jmir.8793","article-title":"Health information technology continues to show positive effect on medical outcomes: systematic review","volume":"20","author":"Kruse","year":"2018","journal-title":"J Med Internet Res"},{"issue":"2, pt 1","key":"2020110613072654100_ocz092-B10","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1475-6773.2012.01448.x","article-title":"Meaningful use of electronic health record systems and process quality of care: evidence from a panel data analysis of U.S. acute-care hospitals","volume":"48","author":"Appari","year":"2013","journal-title":"Health Serv Res"},{"issue":"4","key":"2020110613072654100_ocz092-B11","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1177\/1077558707313437","article-title":"Do hospitals with electronic medical records (EMRs) provide higher quality care? 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