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Eur J Public Health. 2016 Feb;26(1):60-4. doi: 10.1093/eurpub/ckv122. Epub 2015 Jun 30.

The impact of electronic health records on healthcare quality: a systematic review and meta-analysis.

Author information

1
Department of Public Health, Catholic University of Sacred Heart, L.go F. Vito 1 00168, Rome, Italy paolo.campanella@icloud.com.
2
Department of Public Health, Catholic University of Sacred Heart, L.go F. Vito 1 00168, Rome, Italy.

Abstract

OBJECTIVE:

To assess the impact of electronic health record (EHR) on healthcare quality, we hence carried out a systematic review and meta-analysis of published studies on this topic.

METHODS:

PubMed, Web of Knowledge, Scopus and Cochrane Library databases were searched to identify studies that investigated the association between the EHR implementation and process or outcome indicators. Two reviewers screened identified citations and extracted data according to the PRISMA guidelines. Meta-analysis was performed using the random effects model for each indicator. Heterogeneity was quantified using the Cochran Q test and I2 statistics, and publication bias was assessed using the Egger's test.

RESULTS:

Of the 23 398 citations identified, 47 articles were included in the analysis. Meta-analysis showed an association between EHR use and a reduced documentation time with a difference in mean of -22.4% [95% confidence interval (CI) = -38.8 to -6.0%; P < 0.007]. EHR resulted also associated with a higher guideline adherence with a risk ratio (RR) of 1.33 (95% CI = 1.01 to 1.76; P = 0.049) and a lower number of medication errors with an overall RR of 0.46 (95% CI = 0.38 to 0.55; P < 0.001), and adverse drug effects (ADEs) with an overall RR of 0.66 (95% CI = 0.44 to 0.99; P = 0.045). No association with mortality was evident (P = 0.936). High heterogeneity among the studies was evident. Publication bias was not evident.

CONCLUSIONS:

EHR system, when properly implemented, can improve the quality of healthcare, increasing time efficiency and guideline adherence and reducing medication errors and ADEs. Strategies for EHR implementation should be therefore recommended and promoted.

PMID:
26136462
DOI:
10.1093/eurpub/ckv122
[Indexed for MEDLINE]

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