Impact of electronic medical records (EMRs) on hospital productivity in Japan

• Published in: International journal of medical informatics (Shannon, Ireland) Vol. 118; pp. 36 - 43
• Main Authors: Kaneko, Kozo, Onozuka, Daisuke, Shibuta, Hidetoshi, Hagihara, Akihito
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.10.2018
• Subjects: Efficiency, Organizational - statistics & numerical data; Electronic Health Records - statistics & numerical data; Electronic medical records; Hospital performance; Hospitals - statistics & numerical data; Humans; Japan; Practice Patterns, Physicians' - statistics & numerical data; Productivity; Retrospective Studies; Japan; Productivity; Hospital performance; Electronic medical records
• ISSN: 1386-5056; 1872-8243
• DOI: 10.1016/j.ijmedinf.2018.07.008

Consistent with the global trend, Japanese hospitals have increasingly adopted electronic medical record (EMR) systems in the last 20 years. Although improved productivity is emphasized as one of the benefits of information technology (IT), there is a paucity of data regarding how the use of EMR systems influences the productivity of Japanese hospitals. This retrospective study focused on 658 municipal hospitals. The study period was from 2006 to 2015. We analyzed the labor productivity and multi-factor productivity (MFP) of the hospitals and their average rate of change during the study period. Logistic regression models were used to assess how EMR implementation influenced labor productivity and MFP growth. We considered the duration of EMR operation, and hospitals using EMRs were divided into three groups based on tertiles of time elapsed since the implementation of the EMR system: “early adopters”, “followers”, and “late adopters”. We found that the implementation of an EMR system had a significantly negative impact on MFP growth for the ‘late adopters’ (OR 0.51; 95%CI 0.31–0.82; p = 0.006). No significant association was found between EMR implementation and labor productivity growth. EMR implementation has an adverse effect on the productivity of municipal hospitals in Japan. This finding should be considered when developing future healthcare policies promoting the implementation of IT.