Does the meaningful use of electronic health records improve patient outcomes?

While Electronic Health Records (EHRs) hold the promise of improving patient outcomes, past research on their efficacy has yielded inconsistent results. In this study, we overcome several drawbacks of past research by examining not just partial versus full adoption, but the impact of meaningful assimilation of EHRs as mandated by the HITECH (Health Information Technology for Economic and Clinical Health) Act. Detailed patient-level data from acute-care hospitals in California, coupled with relevant data from several other sources, is used to conduct our analysis. After controlling for self-selection bias, our results show that overall length of stay (LOS) is reduced by 3%, on average, for all patients who undergo treatment at hospitals that are meaningful-use assimilated, relative to patients at hospitals that have fully adopted EHRs. The magnitude of this reduction is increased for patients with greater comorbidity complexity and greater coordination complexity. In addition, we find an overall decrease in readmission. We do not find such benefits among full adopters of EHRs. Thus, our study provides empirical evidence that instead of merely adoption, assimilation of EHRs at a hospital-wide level can improve the efficiency with which patients are treated, with benefits from such an assimilation being far more pronounced for patients with a greater degree of health complexities. These are important findings, because hospitals are struggling to deliver quality care to their sickest patients without severe cost overruns. Recommendations from our study point to a path forward in meeting this challenge.