54 Chapter 4 ABSTRACT Background Experts consider health information technology key to improving efficiency and quality of health care. The purpose of this study is to explore the association between the use of Electronic Medical Record (EMR) technologies in Dutch hospitals and patient safety outcomes. The outcomes studied were the number of adverse events (AE), preventable AEs, medication related AEs, preventable medication-related AEs, unplanned readmissions and the length of hospital stay. Methods Two data sets were leveraged for this study: the HIMSS (Health Information Management Systems Society) Analytics Electronic Medical Record Adoption Model (EMRAMSM) and the Netherlands Institute for Health Services Research (NIVEL) database. A total of 17 hospitals with a valid EMRAM score and associated NIVEL patients (n=3,436) during the study period were included in the comparative set. A multilevel binomial regression method (adverse events and unplanned readmissions) and linear regression analyses (length of stay) were used to investigate the association, while adjusting for overrepresentation of deceased patients, differences in hospital departments and hospital types. Results and conclusions An association between the use of EMRs and patient safety outcomes could not be confirmed. This might be caused by the small number of participating hospitals. Another reason could be the status of implementing EMR capabilities in the Netherlands. As many hospitals in the Netherlands are investing in information technology on a large scale by replacing their EMR systems it is expected this may change in the nearby future. Further research in the future may provide clarity. Keywords: Electronic Medical Records, Adverse Events, patient safety, length of stay, EMRAM.
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