Effects of electronic medical record in a Chinese hospital: A time series study

摘要

Background: Electronic medical record (EMR) systems have potential to improve care quality and efficiency. Yet little is known about the effects of EMR in Chinese hospitals. Objective: An inpatient EMR system was implemented in a large Chinese hospital. The objective of this research was to evaluate the impact of the EMR system on efficiency, quality, and cost of inpatient care in the hospital. Methods: A five-year (2005-2009) longitudinal dataset with monthly data involving 251 physicians and 298,760 patient visits was created by querying the hospital's central database. Four key outcomes were examined: length of stay, infection rate, mortality rate, and cost per patient stay. Interrupted time series analysis was used to evaluate changes in level and slope for each outcome variable. Results: Length of stay grew at 0.027 bed-days per month in the pre-EMR period and declined at 0.043 bed-days per month in the post-EMR period. Infection rate rose at 0.036 infections per 100 patients per month in the pre-EMR period and declined at 0.062 infections per 100 patients per month in the post-EMR period. Mortality rate grew at 0.048 deaths per 1000 patients per month in the pre-EMR period and decreased at 0.005 deaths per 1000 patients per month in the post-EMR period. Cost per patient stay declined at 33 RMB per month in the pre-EMR period and increased at 16 RMB per month in the post-EMR period. Conclusions: The EMR was associated with the declining patterns of length of stay, infection rate, and mortality rate. It had no positive effect on patient costs.