Looking Behind the Curtain: Identifying Factors Contributing to Changes on Care Outcomes During a Large Commercial EHR Implementation.

Objective: To identify factors contributing to changes on quality, productivity, and safety outcomes during a large commercial electronic health record (EHR) implementation and to guide future research.

Methods: We conducted a mixed-methods study assessing the impact of a commercial EHR implementation. The method consisted of a quantitative longitudinal evaluation followed by qualitative semi-structured, in-depth interviews with clinical employees from the same implementation.

Comprehensive methodology to monitor longitudinal change patterns during EHR implementations: a case study at a large health care delivery network.

Objective: To test a systematic methodology to monitor longitudinal change patterns on quality, productivity, and safety outcomes during a large-scale commercial Electronic Health Record (EHR) implementation.

Materials And Methods: Our method combines an interrupted time-series design with control sites and 41 consensus outcomes including quality (11 measures), productivity (20 measures), and safety (10 measures). The intervention consisted of a phased commercial EHR implementation at a large health care delivery network.

Development and classification of a robust inventory of near real-time outcome measurements for assessing information technology interventions in health care.

Objective: To develop and classify an inventory of near real-time outcome measures for assessing information technology (IT) interventions in health care and assess their relevance as perceived by experts in the field.

Materials And Methods: To verify the robustness and coverage of a previously published inventory of measures and taxonomy, we conducted semi-structured interviews with clinical and administrative leaders from a large care delivery system to collect suggestions of outcome measures that can be calculated with data available in electronic format for near real-time monitoring of EHR implementations. We combined these measures with the most commonly reported in the literature.

Health information technology adoption: Understanding research protocols and outcome measurements for IT interventions in health care.

Objective: To classify and characterize the variables commonly used to measure the impact of Information Technology (IT) adoption in health care, as well as settings and IT interventions tested, and to guide future research.

Materials And Methods: We conducted a descriptive study screening a sample of 236 studies from a previous systematic review to identify outcome measures used and the availability of data to calculate these measures. We also developed a taxonomy of commonly used measures and explored setting characteristics and IT interventions.