Background and Purpose of the Study: The U.S. healthcare system at 3trillion,isthesixthlargesteconomyintheworld.Thefederalgovernmentisthelargestpurchaserofhealthcareinthecountry.Inthepastdecadeithasbeenonaquesttorefocusitspurchasingfromvolumetovalue.Whilespendingnearlydoublepercapitathaneveryotherindustrializednation,U.S.healthcareoutcomesareconsistentlyinthelowestquartileforeverymajorindicatorfromlifeexpectancytoambulatorysensitiveconditions.TheCrossingtheQualityChasmReport(IOM)focusedalensonthedearthofelectronichealthrecord(EHR)systemsnationally.Resultantlegislation,theHITECHAct,fundeda50 billion investment to close this gap along with promulgation of standards known as Meaningful Use (MU) to achieve interoperability. This investment and related MU protocols for implementation warrant a careful examination to establish if the intended improved outcomes have been achieved.
Methods: The study is a cross-sectional, retrospective design; it employs two cohorts, Meaningful Use (MU) vs Non-MU hospitals. Publicly reported data on clinical outcomes, cost and safety from 4221 or 95% of the nation’s hospitals were included in the analysis to identify if there is a difference in outcomes between the hospital cohorts.
Results: 2315 of the 4221 or 55% hospitals who were included in the study met MU standards by 2013. The profile of an MU hospital was a non-teaching (70%), geographically southern (40%), not-for-profit hospital (61%). Non-Mu hospital had a similar profile, 78% non-teaching, 35% Southern and 60% not-for-profit. Those hospitals who met MU had statistically lower mortality (p
Conclusion: The HITECH Act that committed over $50 billion in subsidy incentive funds has dramatically increased EHR adoption nationally from 8% in 2009 to over 50% by 2013. The results from this suggest hospitals that had implemented EHRs’ that meet MU standards demonstrate mortality and cost outcomes that result in statistically significant cost and clinical care benefit
