Getting Value From Electronic Health Records: Research Needed to Improve Practice

被引:26
|
作者
Rudin, Robert S. [1 ]
Friedberg, Mark W. [1 ,2 ]
Shekelle, Paul [3 ]
Shah, Neel [4 ]
Bates, David W. [4 ,5 ]
机构
[1] RAND Corp, 20 Pk Plaza,Suite 920, Boston, MA 02116 USA
[2] Blue Cross & Blue Shield Massachusetts, Boston, MA USA
[3] RAND Corp, 1776 Main St, Santa Monica, CA 90401 USA
[4] Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy & Management, 677 Huntington Ave, Boston, MA 02115 USA
[5] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA
关键词
SHARED DECISION-MAKING; BAR-CODE TECHNOLOGY; EARLY-ONSET SEPSIS; CARE; INFORMATION; INTERVENTION; QUALITY; ADULTS; RISK;
D O I
10.7326/M19-0878
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Electronic health records (EHRs) are now widely adopted in the United States, but health systems have barely begun using them to deliver high-value care. More directed and rigorous research is needed to fulfill the promise of EHRs to not only store information but also support the delivery of better care. This article describes 4 potential benefits of EHR-based research: improving clinical decisions, supporting triage decisions, enabling collaboration among the care team (including patients), and increasing productivity via automation of tasks. Six recommendations are made for conducting and reporting research to catalyze value creation: develop interventions systematically by using user-centered design and a building-block approach; assess value in terms of cost, quality, outcomes, and work required of providers and patients; consider the time horizon for the intervention; test best practices for implementation in a range of real-world contexts; assess subtleties of behavior change tools used to improve high-value behaviors; and report the intervention in enough detail that it can be replicated, including context. Just as research played a critical role in developing early EHR prototypes and demonstrating their value to justify dissemination, research will continue to be essential in the next phase: expanding EHR-based interventions and maximizing their role in creating value.
引用
收藏
页码:S130 / S136
页数:7
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