The impact of electronic health records on healthcare quality: a systematic review and meta-analysis

Objective: To assess the impact of electronic health record (EHR) on healthcare quality, we hence carried out a systematic review and meta-analysis of published studies on this topic.

Methods: PubMed, Web of Knowledge, Scopus and Cochrane Library databases were searched to identify studies that investigated the association between the EHR implementation and process or outcome indicators. Two reviewers screened identified citations and extracted data according to the PRISMA guidelines. Meta-analysis was performed using the random effects model for each indicator. Heterogeneity was quantified using the Cochran Q test and I2 statistics, and publication bias was assessed using the Egger’s test.

Results: Of the 23 398 citations identified, 47 articles were included in the analysis. Meta-analysis showed an association between EHR use and a reduced documentation time with a difference in mean of −22.4% [95% confidence interval (CI) = −38.8 to −6.0%; P < 0.007]. EHR resulted also ...

Era 3 for Medicine and Health Care

In this Viewpoint, Berwick discusses 2 “eras” of the medical profession and offers changes that would be useful to move into a new “moral era.”

Constant conflict roils the health care landscape, including issues related to the Affordable Care Act, electronic health records, payment changes, and consolidation of hospitals and health plans. The morale of physicians and other clinicians is in jeopardy.

Building Competencies for Integrated Care: Defining the Landscape

As the discussion in integrated care moves from "what needs to be done?" to "how to do we achieve sustainable change?" one of the key questions is "how do we get people to change?". Electronic health records, budgetary processes and governance structures are all important building blocks but achieving the transformation required will ultimately stand or fall on changing how we act. Therefore at the heart of this complexity are two more simple, yet profound questions: how do we learn? And who do we learn from?

Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal

Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. This article describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal.

The Impact of Patient-Centered Care on Cancer Patients’ QOC, Self-Efficacy, and Trust Towards Doctors: Analysis of a National Survey

Patient-centered approaches impact cancer patients’ perceptions and outcomes in different ways. This study explores the impact of patient-centered care practices on cancer patients’ quality-of-care (QOC), self-efficacy, and trust in their doctors.