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Am J Manag Care. 2019 Jul;25(9 Suppl):S159-S165.
Improvements in patient outcomes from the meaningful use of electronic health records (EHRs) have not been extensively studied among patients with schizophrenia. This study assessed the association between EHR use, provision of quality care, and patient outcomes. Providers who were at least 50% compliant with current requirements for the CMS Electronic Health Records Incentive Program were classified as EHR providers. Quality of mental health care was assessed using 4 Healthcare Effectiveness Data and Information Set indicators. Patient outcomes included inpatient admissions and emergency department visits. A total of 18,305 providers (EHR: 16.6%; non-EHR: 83.3%) treated 27,153 patients with schizophrenia. EHR use was associated with improved rates of diabetes screening (77.9% vs 72.4%; P <.001), diabetes monitoring (72.1% vs 61.4%; P <.001), and better antipsychotic adherence (54.7% vs 36.6%; P <.001). EHR use was also associated with fewer inpatient admissions (15.9% vs 25.2%; P <.001) and emergency department visits (32.2% vs 49.3%; P <.001). These data suggest that EHR use may have a positive influence on the process and outcomes of psychiatric care when treating patients with schizophrenia. More research is needed to identify the drivers of the influence of EHRs and to develop programs that ensure all EHR users enjoy the same potential benefits as demonstrated here.
电子健康记录(EHR)的实际使用对精神分裂症患者的治疗效果的改善作用尚未得到广泛研究。本研究评估了 EHR 使用、提供高质量护理与患者治疗效果之间的关联。符合当前 CMS 电子健康记录激励计划的至少 50%的现行要求的提供者被归类为 EHR 提供者。使用 4 个医疗保健效果数据和信息集指标评估精神卫生保健质量。患者治疗效果包括住院治疗和急诊就诊。共有 18305 名提供者(EHR:16.6%;非 EHR:83.3%)治疗了 27153 名精神分裂症患者。EHR 使用与糖尿病筛查率(77.9% vs 72.4%;P<.001)、糖尿病监测率(72.1% vs 61.4%;P<.001)和改善抗精神病药物治疗依从性(54.7% vs 36.6%;P<.001)相关。EHR 使用还与减少住院治疗(15.9% vs 25.2%;P<.001)和急诊就诊(32.2% vs 49.3%;P<.001)相关。这些数据表明,在治疗精神分裂症患者时,EHR 使用可能对精神科护理的过程和结果产生积极影响。需要进一步研究以确定 EHR 影响的驱动因素,并制定确保所有 EHR 用户都能享受与本研究中所示相同潜在益处的计划。