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Value of Electronic Health Records since HITECH: A Literature Review

Electronic health records (EHR) have become an integral part of the modern health system as a result of government regulations, technology advancements, health care challenges, and market conditions. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was a large-scale federal effort to increase the adoption of EHRs. The ultimate goal was to reduce healthcare costs, improve care quality and safety, and increase patient satisfaction through incentives for providers and organizations that exhibited meaningful use of a certified EHR system. Approximately $27 billion in incentives were awarded to physicians and hospitals that attested to the federally defined “meaningful use” (MU) criteria. Considering the cost and complexity of an EHR system, a positive return is expected. The goal of this study is to perform a value analysis of EHR for hospitals after HITECH Act was enacted. This study utilizes Atlas.ti to perform qualitative analysis for the literature review for value analysis of EHRs. First, we searched the bibliographic databases of PubMed, Scopus, and CINAHL in order to identify empirical, peer reviewed studies in the area of value analysis of EHR in the period from January 2009 to March 2018. Second, we added final 23 articles into Atlas.ti document list (Figure 1). We then performed a full text review for each article and identified recurring topics. Depending on the recurring topics, we identified 25 different codes and assigned topics to its most relevant code. The process included multiple revisions and refining of codes in order to confirm the codes reflected the purpose of the research, were exhaustive, mutually exclusive, sensitizing and conceptually congruent. Preliminary findings of our literature review suggest that value can be defined in terms of financial, clinical, and social outcomes and an integration of all three outcomes may provide a more holistic view of value of the EHR.