A longitudinal study conducted by the Rand Corporation on electronic health record adoption and hospital quality shows mixed results, as The Wall Street Journal's Health Blog notes. "On the one hand, the increased improvement in heart failure quality scores over time associated with maintenance of a basic EHR is encouraging. On the other hand, the smaller quality gains associated with new adoption or upgrade to an advanced EHR are somewhat counterintuitive," the Rand researchers write in The American Journal of Managed Care. First author Spencer Jones tells the Health Blog that complex electronic medical records can be difficult to put in place and to use. Jones also adds that it is "tough to do two things at once," meaning adopt these new systems and increase hospital quality.