TY  - JOUR
AU  - Modi, Shikha
AU  - Feldman, Sue S
AU  - Berner, Eta S
AU  - Schooley, Benjamin
AU  - Johnston, Allen
PY  - 2024
DA  - 2024/1/24
TI  - Value of Electronic Health Records Measured Using Financial and Clinical Outcomes: Quantitative Study
JO  - JMIR Med Inform
SP  - e52524
VL  - 12
KW  - acceptance
KW  - admission
KW  - adoption
KW  - clinical outcome
KW  - cost
KW  - economic
KW  - EHR adoption
KW  - EHR
KW  - electronic health record
KW  - finance
KW  - financial outcome
KW  - financial
KW  - health outcome
KW  - health record
KW  - hospital
KW  - hospitalization
KW  - length of stay
KW  - margin
KW  - moderation analysis
KW  - multivariate
KW  - operating margin
KW  - operating
KW  - operation
KW  - operational
KW  - profit
KW  - project management
KW  - readmission rate
KW  - readmission
KW  - total margin
KW  - value analysis
KW  - value engineering
KW  - value management
AB  - Background: The Health Information Technology for Economic and Clinical Health Act of 2009 was legislated to reduce health care costs, improve quality, and increase patient safety. Providers and organizations were incentivized to exhibit meaningful use of certified electronic health record (EHR) systems in order to achieve this objective. EHR adoption is an expensive investment, given the resources and capital that are invested. Due to the cost of the investment, a return on the EHR adoption investment is expected. Objective: This study performed a value analysis of EHRs. The objective of this study was to investigate the relationship between EHR adoption levels and financial and clinical outcomes by combining both financial and clinical outcomes into one conceptual model. Methods: We examined the multivariate relationships between different levels of EHR adoption and financial and clinical outcomes, along with the time variant control variables, using moderation analysis with a longitudinal fixed effects model. Since it is unknown as to when hospitals begin experiencing improvements in financial outcomes, additional analysis was conducted using a 1- or 2-year lag for profit margin ratios. Results: A total of 5768 hospital-year observations were analyzed over the course of 4 years. According to the results of the moderation analysis, as the readmission rate increases by 1 unit, the effect of a 1-unit increase in EHR adoption level on the operating margin decreases by 5.38%. Hospitals with higher readmission payment adjustment factors have lower penalties. Conclusions: This study fills the gap in the literature by evaluating individual relationships between EHR adoption levels and financial and clinical outcomes, in addition to evaluating the relationship between EHR adoption level and financial outcomes, with clinical outcomes as moderators. This study provided statistically significant evidence (P<.05), indicating that there is a relationship between EHR adoption level and operating margins when this relationship is moderated by readmission rates, meaning hospitals that have adopted EHRs could see a reduction in their readmission rates and an increase in operating margins. This finding could further be supported by evaluating more recent data to analyze whether hospitals increasing their level of EHR adoption would decrease readmission rates, resulting in an increase in operating margins. Hospitals would incur lower penalties as a result of improved readmission rates, which would contribute toward improved operating margins. 
SN  - 2291-9694
UR  - https://medinform.jmir.org/2024/1/e52524
UR  - https://doi.org/10.2196/52524
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38265848
DO  - 10.2196/52524
ID  - info:doi/10.2196/52524
ER  -