Evidence map›Paper›PMID 25298808›Full record

ArticleApplied clinical informatics2014

Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure.

M E Patterson, P Marken, Y Zhong, S D Simon, W Ketcherside

Abstract readComparative Study
In one paragraph

Article in Applied clinical informatics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Electronic health records systems and hospital clinical performance: a study of nationwide hospital data.Journal of the American Medical Informatics Association : JAMIA · 2019
    Article
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

M E PattersonDivision of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy , Kansas City, Missouri.
P MarkenDivision of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy , Kansas City, Missouri.
Y ZhongDepartment of Biostatistics, University of Kansas Medical Center , Kansas City, Kansas.
S D SimonDepartment of Informatics Medicine and Personalized Health, University of Missouri-Kansas City , Kansas City, Missouri.
W KetchersideKetcherside Group, L.L.C. , Kansas City, Missouri.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRegulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors.

objectiveTo compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without.

methodsThis retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias.

resultsThe proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 - 1.3).

conclusionsImplementation of comprehensive electronic health record systems does not necessarily improve a hospital's ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.

Indexed as

Electronic Health RecordsHeart FailureHumansKansasLength of StayMedicarePatient AdmissionPatient ReadmissionPrevalenceRetrospective StudiesUnited StatesElectronic health recordsinpatient carequantitative evaluation

Identifiers

PMID25298808
PMCPMC4187085

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.