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Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry.

Publication ,  Journal Article
Enriquez, JR; de Lemos, JA; Parikh, SV; Simon, DN; Thomas, LE; Wang, TY; Chan, PS; Spertus, JA; Das, SR
Published in: Circ Cardiovasc Qual Outcomes
November 2015

BACKGROUND: In 2009, national legislation promoted wide-spread adoption of electronic health records (EHRs) across US hospitals; however, the association of EHR use with quality of care and outcomes after acute myocardial infarction (AMI) remains unclear. METHODS AND RESULTS: Data on EHR use were collected from the American Hospital Association Annual Surveys (2007-2010) and data on AMI care and outcomes from the National Cardiovascular Data Registry Acute Coronary Treatment and Interventions Outcomes Network Registry-Get With The Guidelines. Comparisons were made between patients treated at hospitals with fully implemented EHR (n=43 527), partially implemented EHR (n=72 029), and no EHR (n=9270). Overall EHR use increased from 82.1% (183/223) hospitals in 2007 to 99.3% (275/277) hospitals in 2010. Patients treated at hospitals with fully implemented EHRs had fewer heparin overdosing errors (45.7% versus 72.8%; P<0.01) and a higher likelihood of guideline-recommended care (adjusted odds ratio, 1.40 [confidence interval, 1.07-1.84]) compared with patients treated at hospitals with no EHR. In non-ST-segment-elevation AMI, fully implemented EHR use was associated with lower risk of major bleeding (adjusted odds ratio, 0.78 [confidence interval, 0.67-0.91]) and mortality (adjusted odds ratio, 0.82 [confidence interval, 0.69-0.97]) compared with no EHR. In ST-segment-elevation MI, outcomes did not significantly differ by EHR status. CONCLUSIONS: EHR use has risen to high levels among hospitals in the National Cardiovascular Data Registry. EHR use was associated with less frequent heparin overdosing and modestly greater adherence to acute MI guideline-recommended therapies. In non-ST-segment-elevation MI, slightly lower adjusted risk of major bleeding and mortality were seen in hospitals implemented with full EHRs; however, in ST-segment-elevation MI, differences in outcomes were not seen.

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Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

November 2015

Volume

8

Issue

6

Start / End Page

576 / 585

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Registries
  • Quality Indicators, Health Care
  • Quality Improvement
  • Process Assessment, Health Care
  • Practice Guidelines as Topic
  • Odds Ratio
  • Myocardial Infarction
  • Multivariate Analysis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Enriquez, J. R., de Lemos, J. A., Parikh, S. V., Simon, D. N., Thomas, L. E., Wang, T. Y., … Das, S. R. (2015). Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry. Circ Cardiovasc Qual Outcomes, 8(6), 576–585. https://doi.org/10.1161/CIRCOUTCOMES.115.001837
Enriquez, Jonathan R., James A. de Lemos, Shailja V. Parikh, DaJuanicia N. Simon, Laine E. Thomas, Tracy Y. Wang, Paul S. Chan, John A. Spertus, and Sandeep R. Das. “Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry.Circ Cardiovasc Qual Outcomes 8, no. 6 (November 2015): 576–85. https://doi.org/10.1161/CIRCOUTCOMES.115.001837.
Enriquez JR, de Lemos JA, Parikh SV, Simon DN, Thomas LE, Wang TY, et al. Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry. Circ Cardiovasc Qual Outcomes. 2015 Nov;8(6):576–85.
Enriquez, Jonathan R., et al. “Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry.Circ Cardiovasc Qual Outcomes, vol. 8, no. 6, Nov. 2015, pp. 576–85. Pubmed, doi:10.1161/CIRCOUTCOMES.115.001837.
Enriquez JR, de Lemos JA, Parikh SV, Simon DN, Thomas LE, Wang TY, Chan PS, Spertus JA, Das SR. Modest Associations Between Electronic Health Record Use and Acute Myocardial Infarction Quality of Care and Outcomes: Results From the National Cardiovascular Data Registry. Circ Cardiovasc Qual Outcomes. 2015 Nov;8(6):576–585.

Published In

Circ Cardiovasc Qual Outcomes

DOI

EISSN

1941-7705

Publication Date

November 2015

Volume

8

Issue

6

Start / End Page

576 / 585

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Registries
  • Quality Indicators, Health Care
  • Quality Improvement
  • Process Assessment, Health Care
  • Practice Guidelines as Topic
  • Odds Ratio
  • Myocardial Infarction
  • Multivariate Analysis