Electronic Thesis/Dissertation


The Unintended Negative Consequences of Electronic Health Records (EHR) in the Healthcare Enterprise Open Access

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Usage of Electronic Health Records (EHR) systems can lead to an increase in preventable adverse events (PAEs), to include injuries and death, thereby negatively impacting the quality of patient care in U.S. hospitals. Government policy regulations and financial incentives have led to a large-scale transformation from paper to EHR systems, with an aim to better manage and utilize patient data, reduce costs, and increase efficiencies throughout the U.S. healthcare system. Despite the realization of numerous benefits, there is growing concern with the unintended consequences of EHR systems utilization. Analysis of data gleaned from recent case and patient safety reports, malpractice claims databases, and in-hospital electronic patient surveillance, attribute a growing proportion of PAEs to EHR systems usage. Using malpractice data from the CRICO claims database, a baseline model that incorporates hospital staffs’ perception of and exposure to EHR systems is developed. Then multiple simulations to assess the long-term impact of EHR systems usage on the incidence rate of PAEs are performed. A critical finding of this work is that yearly PAEs steadily increase based on the interplay of EHR implementation, cost, and regulatory variables. We conclude with a discussion of the results, and suggestions for future research.

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