Study Shows Improved Patient Care When Hospitals Choose Single Vendor for Medical Records Software | News | Notre Dame News

Electronic medical records (EMRs) are digital versions of paper medical office and hospital records that contain notes and information collected by and used by healthcare providers. Digitally stored information can be shared between healthcare facilities, and a properly implemented system enables providers to document and monitor patient care.

Hospitals can choose to purchase all EMR components in a suite from a single vendor (single-sourcing) or they can use multiple vendors (multi-sourcing).

New research from the University of Notre Dame shows for the first time that the procurement strategy chosen by hospitals has an impact on the quality of patient care. When hospitals move closer to a single-source strategy, patients receive better evidence-based care.

With multiple sourcing strategies, mismatches between vendor components can create situations where key medical concepts do not have the same meaning, which can disrupt data exchange and reduce the quality of care provided. For example, allergies might be defined and coded differently in EMR components by different vendors.

“Strategic sourcing of multi-component software systems: The case of electronic medical records” is forthcoming in the journal Decision Sciences by lead author Kaitlin Wowak; Ken Kelley and Corey Angst, professors of information technology, analytics, and operations at Notre Dame’s Mendoza College of Business; and Sean Handley of the University of South Carolina.

Using data from US hospitals that operated continuously from 2006 to 2013 and analyzing changes over time, the team examined how a key dimension of procurement strategy for EMR systems – the change in proximity to sole sourcing – impacts quality of compliance, a critical hospital metric. performance that assesses how often hospitals adhere to evidence-based practices.

They found that moving closer to the single-source approach increases the quality of compliance, but the positive effect is reduced over time, meaning that the benefits realized by hospitals using a single-source approach become less substantial the longer they are. late in the observation period.

“Our study provides much-needed insight into the implications of an organization’s sourcing strategy for multi-component software systems, which are increasingly prevalent in modern organizations,” Wowak said. “We show that how EMRs are implemented, not just if, impacts the quality of patient care.

“Administrators need to consider how the number of different vendors affects routines, interoperability (the ability of two different components to receive and send data), and ultimately quality of conformance. ”

Wowak says aligning supply strategy with technical and operational considerations is likely to result in better patient care. The study shows that the size of the effect has considerable practical significance, as a shift to a single source corresponds to more patients receiving appropriate care as a result.

“To put that into perspective, during the period of our study, American hospitals admitted about 35 million patients a year,” Kelley said. “All other things being equal, if hospitals moved ever so slightly closer to single-source in a given year, say 0.5 units, about 175,000 more patients per year would have received evidence-based care.”

Because hospital performance can often mean the life or death of patients, the team hopes this study will help lay the groundwork for future research into the relationship between health IT, procurement decisions and performance. hospitals.

“Even though there are industry efforts to help translate key concepts between components from different vendors to improve interoperability, competing EMR companies have little incentive to get their systems up and running. communicate with competing systems,” Angst said. Thus, integrating one system with another is time-consuming, costly, and potentially error-prone.

With 37 combined years of EMR research at Notre Dame, Wowak is the Robert and Sara Lumpkins Associate Professor of Business Analytics; Kelley is Professor of Computing, Analytics, and Operations at the Edward F. Sorin Society; and Angst is a professor of computer science, analytics, and operations at Jack and Joan McGraw Family Collegiate.

Contact: Kaitlin Wowak, 574-631-6685,

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