Abstract 2382: The Influence of Electronic Health Records on Quality of Care for Heart Failure
Electronic health records (EHR) are purported to be an important technology to improve the quality of health care, yet few data exist regarding the effect of EHR on the delivery of evidence-based care in the outpatient setting. This study evaluates the influence of contemporary EHR on adherence to evidence-based guidelines for treatment of heart failure (HF) among outpatient cardiology IMPROVE HF is a prospective cohort study of 15,381 patients with diagnosed HF or prior myocardial infarction and EF ≤ 35% receiving care at 167 US outpatient cardiology practices. Data on baseline patient characteristics and care practices were collected by chart abstraction. To quantify guideline adherence, 7 individual care metrics were assessed. Practices with EHR, including those with mixed EHR/paper systems, and those without EHR were compared. Conformity with recommended guidelines included only patients without contraindications or intolerance to therapy. Among practices, 69% were non-teaching and 87 (52%) had EHR (50 EHR only, 37 EHR/paper) and 80 (48%) paper only. Patients were 71% male, median age 70, median EF 25%, and were similar between practices with and without EHR. Compared to practices without EHR, conformity with indicated care measures for practices with EHR differed significantly for 2 of the 7 measures (Table⇓). After controlling for other site characteristics, use of EHR was associated with improvement in the delivery of quality care on 1 of 7 care measures. These data are among the first to assess the influence of contemporary EHR platforms on conformity with evidence-based guidelines for HF patients in the outpatient setting. Findings suggest that current use of EHR results in little improvement in the quality of HF care compared with paper-based systems. Additional research is required.