Introduction: Improvement and Measurement in the Era of Electronic Health Records

Physican With Computer Keyboard

Andrew Auerbach and David W. Bates
Annals of Internal Medicine
2020;172:S69-S72. doi:10.7326/M19-0870

Since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act (1), health care has undergone a sea change with the widespread implementation of electronic health records (EHRs). In the decade since HITECH, EHRs are now nearly universal throughout the United States, producing innumerable implications for care delivery. Changes in care delivery are also producing dramatic effects on the ways in which quality improvement is carried out and measured. However, how improvement and measurement efforts in the EHR era are carried out may not be keeping pace with improvements in how local improvement programs can create generalizable knowledge—a step that requires consideration of not only the rigor of the implementation, but also the rigor of with which the improvement is reported.

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