Table 1.
Characteristics and overview of included studies.
| ID | Authors | Study type | Type of EMR systems | Country of study | Data year | Research questions | Methods of analysis / evaluation |
|---|---|---|---|---|---|---|---|
| 3 | Beresniak et al. (2016) | CBA | EHR4CR | Europe/Global | 2012–2013 | To conduct a CBA to assess the potential added value of EHR4CR in the pharmaceutical industry compared to current practice, utilizing oncology clinical trials as a reference case | Cost benefit analysis |
| 2 | Li et al. (2012) | CBA | EMR | China | 2006–2010 | To conduct a perspective cost-benefit study to analyze the financial effects of EMR implementation compared to traditional paper records | Cost benefit analysis |
| 1 | Choi et al. (2013) | CBA | EMR | Korea | 2006–2012 | To analyze the economic effects of EMR in a hospital by conducting a CBA on differential costs of managerial accounting | Cost benefit analysis |
| 11 | Nuckols et al. (2015) | Cost effectiveness analysis | CPOE | USA | 2013 | To determine the probability that a CPOE system creates societal financial savings upon implementation | Probabilistic model |
| 12 | Sevick et al. (2017) | Cost effectiveness analysis | EDCT | Canada | 2012–2013 | To complete an economic evaluation within a randomized controlled trial comparing the use of an electronic discharge communication tool compared with usual care. | Bootstrapping analysis and sensitivity analysis |
| 15 | Ben-Assuli et al. (2016) | Cost effectiveness analysis | EHR | Israel | 2016 | To investigate the relationship between EHR and the financial and clinical outcomes in an emergency department through the use of simulation and Markov model | Markov model |
| 13 | Spaulding et al. (2013) | Cost study | CPOE | USA | 2007 | To assess the impact of CPOE systems usage on cost and process quality in the medication management process | Heckman selection correction to create ordered Probit model |
| 10 | Kazley et al. (2014) | Cost Study | EHR | USA | 2009 | To determine whether advanced EHR use in hospitals is associated with lower cost of providing inpatient care. | Generalized linear model |
| 14 | Teufel et al. (2012) | Cost study | EMR | USA | 2009 | To determine whether delivering care with advanced-stage EMR was associated with a decreased cost per case in a national sample of hospitalized children | Bivariate analysis |
| 6 | Dranove et al. (2014) | Cost study | EMR | USA | 1996–2009 | To conduct an empirical examination of the impact of EMR adoption on hospital operating cos | Linear regression with fixed effects |
| 5 | Atasoy et al. (2018) | Cost study | EHR | USA | 1998–2010 | To analyze the spill over effects of EHR adoption of each hospital on the costs of neighboring hospitals in the same Health Service Area (HSA) and identify if spill over effects occur | Econometric modeling |
| 27 | Zhivan et al. (2012) | Efficiency and productivity analysis | CPOE | USA | 2006 | To empirically examine the association between hospital inefficiency and the decision to introduce EMRs and CPOEs in a national sample of U.S. general hospitals in urban areas in 2006 | Logistic regression |
| 18 | Eastaugh et al. (2012) | Efficiency and productivity analysis | EHR | USA | 2008–2011 | To determine what factors, increase the adoption rate of EHR in hospitals and to assess the effectiveness of the system in staff scheduling | Logit regression |
| 9 | Furukawa et al. (2010) | Efficiency and productivity analysis | EMR | USA | 1998–2007 | To examine the impact of EHRs on cost efficiency in hospital medical-surgical units | Stochastic Frontier analysis |
| 8 | Dupont et al. (2017) | Financial analysis | EHR4CR | Europe | 2007–201 | To assess the financial sustainability of exploiting the EHR4CR platform from the perspective of an EHR4CR service provider in the context of clinical research | Market analysis, value change, business model simulation |
| 7 | Driessen et al. (2013) | Financial analysis | EMR | Malawi | 2010–2011 | To model the financial effects of implementing a hospital wide EMR system in a tertiary facility in Malawi | Financial discounting using actual cost and counter-factual data |
| 17 | Gowrisankaran et al. (2016) | Impact Study | CPOE | USA | 2006–2010 | To evaluate if the adoption of EHRs leads to increases in billing practices | Econometric modeling |
| 22 | Haque et al. (2015) | Impact study | CPOE & EMR | USA | 2008–2011 | To determine the impact of EMRs on the clinical outcomes of patients | Difference in differences model |
| 24 | Hydari et al. (2019) | Impact study | CPOE & EMR | USA | 2005–2014 | To determine the impact that advanced EMRs have on patient safety events | Difference in differences method |
| 21 | Freedman et al. (2014) | Impact Study | CPOE & PD | USA | 2003–2010 | To study the effect of EMR hospital adoption on patient safety and health indicators | Empirical model created through econometrics techniques |
| 16 | DesRoches et al. (2010) | Impact Study | EHR | USA | 2008–2009 | To assess whether EHR adoption was linked with better performance on standard process-of-care measures including lower mortality, readmissions rates, length of stay and inpatient costs | Multivariate model |
| 4 | Iturrate et al. (2016) | Impact Study | EHR with modified ordering system | USA | 2013–2015 | To observe the change in laboratory utilization after the repeat order system on EHR is disabled | Pre- and post-intervention as a continuous variable with an approximately normal distribution using Student’s t test. Additionally, we used an interrupted time series design and performed segmented regression analysis, which divided our time series into pre- and postintervention segments. |
| 28 | Zlabek et al. (2011) | Impact Study | EHR, CPOE | USA | 2007–2009 | To examine the effects of an inpatient EHR system with CPOE on selected measures of cost of care and patient safety | Descriptive statistics with t-tests and chi-squared tests |
| 25 | Miller et al. (2011) | Impact Study | EMR | USA | 1995–2006 | To assess the impact of EMR adoption on neonatal mortality rates | Panel model with fixed effects |
| 26 | Xue et al. (2012) | Impact study | EMR | China | 2005–2009 | To evaluate the impact of the EMR system on efficiency, quality, and cost of inpatient care in the hospital | Interrupted time series analysis |
| 20 | Encinosa et al. (2012) | Impact Study | EMR | USA | 2001–2007 | To assess the impact of EMR on patient safety once a patient safety event has occurred | Multivariate regression analysis |
| 19 | Encinosa et al. (2013) | Impact Study | EMR | USA | 2010 | To examine what impact the adoption of meaningful EMR usage has on hospital-acquired adverse drug events and their costs in 2010 | Regression analysis |
| 23 | Himmelstein et al. (2010) | Impact study | EHR | USA | 2003–2007 | To assess if there is a correlation with a hospital’s computerization score and the cost or quality of patient care | Bivariate analysis; Multivariate analysis |
EMR electronic medical records, EHR electronic health records, EHR4CR electronic health records for clinical research, CPOE computerized physician order entry, EDCT electronic discharge communication tool, PHR personal health record.