EHR data increasingly used to inform clinical care decisions

By | April 18, 2019

Dive Brief:

  • In 2017, 94% of U.S. hospitals used their EHR data in ways that inform clinical practice, up from 87% in 2015 and equal to 2016 usage, new data released by the Office of the National Coordinator for Health Information Technology shows. 
  • The most frequent use of EHR data was to support quality improvement (82%), followed by monitoring patient safety (81%) and measuring organization performance (77%). Hospitals with the capability to send, find, receive and integrate data from outside organizations were twice as likely to use their EHR data as hospitals without that degree of interoperability.
  • Hospitals’ use of EHR data varied by vendor. While the vast majority of hospitals with Epic, Meditech and Cerner EHRs regularly used their data for tasks that inform clinical practice, that was not the case with hospitals using other EHR products.

Dive Insight:

Hospitals are starting to leverage their EHR data in meaningful ways that can impact patient care and outcomes, and those with more mature systems are also seeing an added benefit: happier physicians and better teamwork.

According to a recent report by HIMSS Analytics and KLAS Research’s Arch Collaborative, 41% of hospitals that achieve Stage 7 of HIMSS Analytics EMR Adoption Model (EMRAM) report above average satisfaction with EHRs, with 14% citing high satisfaction and 3% claiming extremely high satisfaction. That’s a breakthrough for a technology that has been associated with physician burnout and stress.

Meanwhile, an ONC report showed most hospitals provide patients electronic access to their medical records, with 72% supporting viewing, downloading and transmitting of records — though patient engagement has lagged.

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But hospitals are finding more ways to use the reams of data collected in EHRs, and that’s good for patients. For the second straight year, hospitals used EHR data to perform on average seven of 10 processes that inform clinical decisionmaking, up from six the in 2015, according to an ONC data brief. Among hospitals with Epic, Cerner and Meditech EHRs, the highest use was to support quality improvement — at 96%, 89% and 88%, respectively. 

Epic led all other EHR vendors in share of hospitals that engaged in each of 10 metrics of EHR data use that inform clinical practice, with more than 85% engaged on seven of the metrics. Epic users were least likely to use their data to assist with strategic planning (76%).

Hospitals using McKesson, CPSI and MedHost EHRs mostly used their data to monitor patient safety, but CPSI and MedHost users were also more likely to not use EHR data at all.

In addition to quality improvements, patient safety and measuring an organization’s performance, other popular uses of EHR data included identifying high-risk patients (68%) and informing strategic planning (67%). The least common uses were to identify gaps in patient care (60%), assess adherence to clinical guidelines (59%) and develop an approach to query for patient data (51%).

While most hospitals used their EHR data, usage varied by hospital characteristics. Small, rural, critical access, state and local government and non-teaching hospitals had the lowest rates of EHR data use. The greatest strides in use such data between 2015 and 2017 were seen with for-profit hospitals, which averaged four new measures of EHR data use during that time.

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The report also shows a correlation between hospitals participating in CMS innovation models and higher usage of EHR data, with those hospitals averaging eight use processes in 2017, compared with six for nonparticipants. Hospitals participating in a bundled payment program had the highest use rates at 8.2, followed by patient-centered medical homes (7.9) and accountable care organizations (7.8). The lowest rates of EHR data use were in hospitals that didn’t participate in ACOs, at an average of 6.3.

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