A Framework for Performance Comparison among Major Electronic Health Record Systems

Area of Science:

• Health Informatics
• Health Services Research
• Health Economics

Background:

• Most hospitals use electronic health record (EHR) systems.
• Dissatisfaction with current EHRs prompts consideration of replacements.
• The large number of EHR options complicates selection.

Purpose of the Study:

• To test if different EHR systems yield varying financial and quality performance.
• To present a framework for comparing EHR systems based on organizational outcomes.

Main Methods:

• Utilized a US hospital database (2011-2016).
• Employed ordinary least squares regression with robust standard errors, clustered by year.
• Regressed financial and quality measures against EHR vendor indicators, controlling for other variables.

Main Results:

• Demonstrated that EHR systems influence hospital financial performance (return on assets, bed utilization).
• Showed EHR systems impact quality metrics (HCAHPS summary star rating, Value-Based Purchasing Total Performance Score).
• Developed a framework for distinguishing EHR systems based on these outcomes.

Conclusions:

• A data-driven framework can help hospitals evaluate EHR systems.
• Informed EHR acquisition decisions can be made by analyzing performance data.
• This approach aids hospitals in selecting EHRs aligned with organizational priorities.