Fifth, they suggested the possibility that improvement resources may have been redirected toward EHR implementation rather than quality improvement efforts. "The literature suggests that both tasks (quality improvement and EHR implementation) are resource-intensive, and it is feasible that both processes might suffer if conducted simultaneously and forced to compete for resources."
Sixth, the study "may not have been long enough to fully estimate the relationship between EHR adoption and quality improvement" and said that hospitals that have been using and refining their EHR systems over decades do report improvement in clinician adherence to recommended practices.
And, the authors say that numerous resources to handle some of these challenges are called for in the HITECH legislation and at the Office of National Coordinator for Health Information Technology.
"We believe that these programs are well conceived and anticipate that they will lead to more effective use of EHRs, which will in turn lead to improved quality in U.S. hospitals," they concluded. "However, we are concerned that the standard methods for measuring hospital quality will not be appropriate for measuring the clinical effects of EHR adoption.
"The generally high levels of performance on the Hospital Compare database are to be celebrated, but in going forward, these high levels of performance will make it difficult to detect the effect of EHR adoption on hospital quality."