A Framework for Performance Comparison among Major Electronic Health Record Systems.

While nearly all hospitals have adopted electronic health record (EHR) systems, some are dissatisfied and considering replacement systems to better address unique organizational needs and priorities. With more than 4,000 certified health information technology products available, comparing the vast number of EHR options is complex. This study tested the hypothesis that various EHR systems demonstrate different financial and quality performance and presented a framework for comparison. Using a subscribed database containing US hospitals' observations from 2011 to 2016, we estimated an ordinary least squares regression model with robust standard errors and clustered by year. We regressed the selected finance and quality measures as dependent variables with the vendors' indicators as independent variables, with control variables. This study demonstrated an approach for analyzing performance data to help hospitals distinguish EHR systems on the basis of several organizational outcomes: return on assets, bed utilization rate, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) summary star rating, and value-based purchasing Total Performance Score. This framework will help EHR acquisition teams make informed decisions.