Abstract
ObjectiveCertified Electronic Health Records (EHR) have been shown to improve the health service quality in some health settings, but there is scant evidence related to its adoption in psychiatric hospitals. This paper aimed to examine the relationship between certified EHR adoption and patient experience across psychiatric hospitals in the United States.MethodsA cross-sectional study design compared the difference in patient experience measures between psychiatric hospitals with and without certified EHR. Data were drawn from the American Hospital Association (AHA) Annual Survey Database and Hospital Compare datasets. Eleven publicly reported measures for patient experience from the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (HCAHPS) were applied for analysis. Independent relationship of certified EHR adoption and patient experience was explored with multiple linear regression models adjusted for hospital organizational characteristics.ResultsPositive associations were identified between certified EHR adoption and five patient perception measures—“recommend hospital” (β = 0.66, 95% CI = [0.16,1.16]; t = 2.68, p = 0.010), “overall hospital rating” (β = 0.39, 95% CI = [0.03,0.75]; t = 2.11, p = 0.035), “discharge information” (β = 0.45, 95% CI = [0.03,0.86]; t = 2.09, p = 0.037), “care transition” (β = 0.44, 95% CI = [0.14, 0.75]; t = 2.84, p = 0.005), and “responsiveness of hospital staff” (β = 0.47, 95% CI = [0.04, 0.90]; t = 2.13, p = 0.033).ConclusionOur results suggest the positive association between certified EHR adoption and patient experience. More studies are needed to explore impacts of certified EHR adoption and potential improvement in patient experience to quality of care.
Highlights
Enacted by Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Electronic Health Records (EHR) Incentive Programs have been launched to drive nationwide EHR adoption and meaningful use of health information technology throughout health care settings in the United States (U.S.). [1] An unprecedented progress has been made in utilization of certified EHR in U.S health settings and large numbers of studies have demonstrated its substantial influences on the quality, safety, and efficiency of health services. [2,3,4] psychiatric hospitals are ineligible for the financial incentive programs, and the rate of EHR adoption is noticeably lower among psychiatric hospitals [5, 6] compared to other hospitals
Our results suggest the positive association between certified EHR adoption and patient experience
According to prior published studies conducted in psychiatric settings, positive impacts of certified EHR utilization can be found on the therapeutic communications, [11, 12] hospital readmission, [13] adverse drug events [14] and psychiatrist-patient relationship [15,16,17] as well as other quality measures [18,19,20] based on psychiatric patient or practitioner level instead of hospital level
Summary
Enacted by Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Electronic Health Records (EHR) Incentive Programs have been launched to drive nationwide EHR adoption and meaningful use of health information technology throughout health care settings in the United States (U.S.). [1] An unprecedented progress has been made in utilization of certified EHR in U.S health settings and large numbers of studies have demonstrated its substantial influences on the quality, safety, and efficiency of health services. [2,3,4] psychiatric hospitals are ineligible for the financial incentive programs, and the rate of EHR adoption is noticeably lower among psychiatric hospitals [5, 6] compared to other hospitals. [6, 10] it is necessary to identify the evidence to prove if certified EHR adoption has positive impacts to quality improvement and patient experience in psychiatric hospitals, and if health policymakers should expand the incentive programs to psychiatric hospitals. According to prior published studies conducted in psychiatric settings, positive impacts of certified EHR utilization can be found on the therapeutic communications, [11, 12] hospital readmission, [13] adverse drug events [14] and psychiatrist-patient relationship [15,16,17] as well as other quality measures [18,19,20] based on psychiatric patient or practitioner level instead of hospital level. Some studies suggested that EHR use could significantly improve patient experience [23,24,25] whereas other showed insignificant [26,27,28,29,30] or even inverse associations. [31, 32] most literature on the relationship between patient experience and EHR adoption were conducted in non-psychiatric settings. [9, 22,23,24,25,26,27,28, 30] Due to the confidentiality and sensitive nature in psychiatric records, and the special reliance on information for psychiatric diagnosis and treatment, the findings of previous works in non-psychiatric hospitals may not apply to psychiatric hospitals. [17]
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