A Framework for Contracted Health IT Performance Assessments

Association Between Use of EHR-Generated Dashboards and Hospital Outcomes in 30-Day Heart Failure Readmissions

EXECUTIVE SUMMARY

This study examined whether usage of clinical data from the electronic health record (EHR) to create organizational- and unit-level performance dashboards and assess adherence to clinical practice guidelines is associated with hospital outcomes in risk-adjusted 30-day readmissions for patients with a principal diagnosis of heart failure (HF). It further assesses the association between the metrics of hospital financial health and the usage of those EHR-generated tools.A cross-sectional study design was used. The study used data from the 2016 American Hospital Association Annual Survey Information Technology Supplement, the Pennsylvania Health Care Cost Containment Council's (PHC4's) 2017 Hospital Performance Report, and the PHC4 General Acute Care Hospitals Financial Analysis Report for fiscal year 2017. Contingency tables, likelihood-ratio chi-square tests, and logistic regression were applied for data analysis.Usage of the EHR to assess adherence to clinical practice guidelines and create EHR-generated unit-level performance dashboards, rather than organizational performance dashboards, was more strongly associated with the hospitals' rating in risk-adjusted 30-day readmissions for HF patients. An increase in hospitals' operating margin was associated with greater odds of the usage of the discussed EHR tools, after controlling for hospital control/ownership and the total number of beds.Usage of some EHR-generated analytical tools may be more strongly associated with lower-than-expected 30-day hospital readmissions in HF patients than with other tools. Better hospital financial health is linked with greater uptake of the discussed analytical tools. Further research could help to determine which EHR-generated tools are more effective in improving hospital outcomes in HF.

Error by omission: A lack of integration across implementation and use in structuring health information technology contracts

Limited work identifies best practices to assess functional electronic health record system performance when contracting for health information technology and information technology-related services. Without a set of best practices or specific contracting provisions to assess the performance of electronic health record systems, healthcare providers will not be able to fully leverage the performance of these systems to reduce the cost of care and improve patient outcomes. This work seeks to provide operational considerations and best practices when forming teams to negotiate health information technology system specifications in contracts. To better understand the contracting and performance assessment process, we conducted a cross-sectional survey of eligible healthcare personnel. Our study highlights a potential disconnect between respondents setting contract structure, knowledge of ongoing functional performance assessments in practice, and the relationship to those with direct system involvement to avoid potential legal risk.