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EHRs Could Improve Quality of Care in ICUs

November 2, 2015
by Heather Landi
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Electronic health records (EHRs) may impact patients’ quality of care in intensive care units, according to a study published in the American College of Chest Physicians journal, Chest.

Researchers at the Mount Sinai School of Medicine in New York City conducted the study to assess the trend of key quality measures in a surgical intensive care unit (ICU) following the implementation of the Epic EHR system in a large tertiary hospital.

“Health information technology, and specifically the EHR, is increasingly viewed as a means to provide more coordinated, patient-centered care. There is enormous ongoing investment in EHR development. Few studies consider the impact of EHRs on quality of care in the ICU setting,” the study authors wrote.

The researchers conducted a retrospective chart review of patients admitted to the surgical ICU between January 1, 2009 and December 31, 2013, with data segregated between patients admitted to the SICU two years before and two years after EHR implementation. Data from 2011 was excluded as it was a 12-month transition period to the EHR, according to the study.

The researchers specifically focused on length of stay, mortality, central line associated blood stream infection (CLABSI) rates, clostridium difficile colitis rates, readmission rates and number of coded diagnoses.

The researchers found that after EHR implementation there were significant reductions in CLABSI rates and SICU morality rates. Specifically, the rate of CLABSI per 1,000 catheter days 85 percent lower and the SICU mortality rates was 28 percent lower after EHR implementation. And, after EHR there was a significant increase in the average number of coded diagnoses from 17.8 percent to 20.8 percent, according to the study authors.

“Ongoing quality improvement endeavors may explain the changes in CLABSI and mortality, but these trends invite further study of the possible impact of EHRs on quality of care in the ICU,” the study authors wrote.

However, the study also found no significant change with other quality of care metrics, including length of stay and readmission rates.

The researchers wrote, “Considering the large investment into electronic health records and the high costs associated with ICU care, it’s important to develop EHRs that improve ICU quality of care.”



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