Study: EHRs Alone Have No Effect on Ischemic Stroke Care Quality

May 5, 2015 in News

Ischemic stroke patients at hospitals with electronic health record systems did not have better illness progression or care quality than similar patients at hospitals without EHRs, according to a study published Monday in the Journal of the American College of Cardiology, HealthDay/U.S. News World Report reports (Dotinga, HealthDay/U.S. News World Report, 5/4).

Details of Study

For the study, researchers analyzed data on more than 625,000 patients who received care between 2007 and 2010 at 1,236 U.S. hospitals.

More than 500 of the hospitals had EHRs by the end of the study period, and all the hospitals were participating in the “Get With the Guidelines-Stroke” care quality initiative (Joynt et al., Journal of the American College of Cardiology, May 2015).

All of the patients had ischemic stroke, which is the most common type of stoke, according to HealthDay/U.S. News World Report.

Study Findings

The study found no difference in patients’ quality of care and illness progression between hospitals with EHRs and those without EHRs, including after adjusting the data for certain patient characteristics (HealthDay/U.S. News World Report, 5/4).

However, researchers found that patients who received care at hospitals with EHRs were slightly less likely to have prolonged hospital stays (Tahir, Modern Healthcare, 5/4). Specifically, such patients were less likely to have a length of stay of more than four days (Journal of the American College of Cardiology, May 2015).


Karen Joynt, the study’s lead author, said that researchers expected patients at hospitals with EHRs to have better care quality, particularly considering how EHRs might have helped remind physicians of updated stroke care guidelines that changed significantly over the course of the study.

She added that the study demonstrates that EHR systems need improvements to achieve better outcomes.

Meaningful Use Penalties Should End, Commentary Argues

John Windle, chief of cardiology at the University of Nebraska Medical Center, argued in an accompanying editorial in JACC that the study results indicate that providers should not face penalties for failing to meet meaningful use requirements.

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Modern Healthcare, 5/4).

Windle wrote that EHRs so far have not been shown to improve care efficiency, care quality or outcomes for large groups of individuals.

He wrote that the study “is a wake-up call that we should heed” and stressed that the first priority of EHR systems “must be support of clinical care, not documentation for billing and reimbursement” (HealthDay/U.S. News World Report, 5/4).

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