Lecture:  Impact of EHR on Quality


Assigned Reading

  1. Meaningful use and CMS incentives Intro► Professionals► Hospitals► Video► Federal Register►
  2. Does EHR improve quality of care? Read► No► Yes►
  3. Impact of Computerized Physician Order Entry (CPOE) Slides► Listen►
  4. CPOE increases mortality  Yes► No►
  5. Unintended Consequences of CPOE   Extent► Types► Consequences►

Narrated slides and videos require Flash. Download►

What do you know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing about what you have read.  The following questions get you to think more about the concepts taught in this session.

  1. What evidence is there that adverse drug effects go down after implementation of electronic health records with computerized physician order entry.  Provide the rate before and after the implementation of CPOE.  Give the source of your claim.
  2. In some studies, the rate of medication errors after implementation of CPOE increases or fails to decrease, what do these studies give as the reason for the effect of CPOE on medication errors (please do not confuse studies on medication error with studies on mortality rates).  Give the source of your claim. 
  3. Discuss the difference of the two studies of impact of CPOE on mortality.  In particular, list what did one study do that the other had not done so that ICU mortality did not go up. 
  4. List 9 ways in which CPOE could lead to unexpected results.
  5. List the requirements for Stage 2 Meaningful Use? Give the source of your claim.  
  6. What are the financial incentives available in Medicare and Medicaid program for adoption of electronic health records?  Give the amount and the criteria that must be met to receive the incentive.
  7. List the impact of EHR on quality.  Do not provide your opinions or experiences but review the evidence in the course or in the literature. 
    • Be brief. Describe one impact per slide.  
    • Cite your work in smaller font on each slide so I can trace your arguments to its source. All slides should have a reference source.
    • Be clear.  Do not extrapolate from studies done in a clinic to studies in hospitals and vice versa.
    • Be visual.  Copy charts or graphs from the papers you have summerized in to the slides and put the text of what your reading and cite your work. 

See an example done by other students: Alex et al► Bank et al►

Do One:  Summarize Findings 

  • Over the past five years, what percent of physicians have reported that their patients had access to Computerized Order Entry? Use Excel to answer. Explain your assumptions.  Data►
  • Create a severity-adjusted, benchmarked report of patient safety problems at different hospitals with the enclosed data.  Download►


For additional information (not part of the required reading), please see the following links:

  1. Meaningful use rap  You Tube►
  2. Slides for John Cuddeback M.D., Ph.D. Lecture  Slides►
  3. Slides for talk by Syed Termizi MD  Slides►
  4. Xu Han presentation of benefits (Chinese) Video►
  5. Jessica Jacobs on Meaningful Use of EHR You Tube►
  6. A list of articles on the impact of Electronic Health Records on cost of care.   Medline Search
  7. Does information technology matter? The relationship between information technology adoption and quality of care   PubMed►
  8. Health IT News  Go
  9. Financial performance of primary care physician practices prior to electronic health record implementation  PPubMed ►
  10. Mind interface with computers  Video► Emotiv Systems► Robotic hand► PPatient with robotic hand ►
  11. The electronic health record and the unlikely prospect of reducing health care costs.   Read►
  12. Introduction to meaningful use You Tube►

This page is part of the course on Information Systems.   This page was edited by Farrokh Alemi, Ph.D.  ęCopyright protected.