The Effects of Electronic Health Records and Teaching Status on Mortality, Cost, and Length of Stay in New York State Hospital

Becoming more efficient in healthcare delivery has been a recurring theme in the U.S. for decades. Several laws have been enacted by Congress over recent decades aimed at incentivizing U.S. healthcare delivery to become more efficient and cost effective. Recently, electronic health records have been touted as a technology-centric path toward healthcare efficiency, with the Federal government incentivizing large-scale adoption of these systems. The evidence to prove that electronic health records lower cost and increase clinical quality is conflicting and nuanced. Additionally, teaching hospitals have historically been outliers for both the quality and the cost of their healthcare services for various reasons. A possible interaction effect between hospital teaching status and electronic health records has not been previously investigated. The purpose of this quantitative correlational study was to examine the performance differences between teaching and non-teaching hospitals in the post-electronic health record implementation landscape, specifically looking at possible interaction effects between electronic health records and hospital teaching status. This research study confirmed previous research that major teaching hospitals cost more and their patients stay in the hospital longer than non-teaching or minor teaching hospitals. Pneumonia risk adjusted mortality was slightly higher at major teaching hospitals. The most salient finding of this study was that electronic health records seem to have no effect on quality, cost, or efficiency in New York State hospitals. This seems to support the notion that electronic health record use and effects may be nuanced and complex. There was also no detected interaction effect between electronic health record status and the teaching status of New York State hospitals.