The Clinical Value of Electronic Health Record: a systematic review and meta-analysis. [Poster]

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 Out of 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% CI = -38.8% – -6.0%; p < 0.007). EHR resulted also associated with a higher guideline adherence with a RR of 1.33 (95% CI = 1.01 – 1.76; p = 0.049) and a lower number of medication errors with an overall RR of 0.46 (95% CI = 0.38 – 0.55; p < 0.001) and adverse drug effects with an overall RR of 0.66 (95% CI = 0.44 – 0.99; p = 0.045). No association with mortality was evident (p = 0.936). High heterogeneity among the studies was evident. Publication bias was not evident. Conclusions EHR system, when properly implemented, can improve quality of healthcare increasing time efficiency and guideline adherence as well as reducing medication errors and adverse drug effects. Strategies for EHR implementation should be therefore recommended and promoted. Key message Information technologies play a growing role in healthcare. Their correct implementation can improve the quality of care and create value in healthcare organizations.