Be Off Electronic Health Records Rose
The implementation of electronic health record
(EHR) systems may not be enough to significantly improve health quality
and reduce costs, argue researchers from the Morgan Institute for
Health Policy at Massachusetts General Hospital. Their findings appear
in Health Affairs.
Currently, implemented EHR systems have little
effect on measures such as patient mortality, surgical complications,
length-of-stay and costs, the authors wrote. They say greater attention
may need to be paid to how systems are being implemented and used, with
the goal of identifying best practices.
"We are still in the early days of electronic
health record adoption, and there’s little evidence for how
best to implement the technology to make the greatest gains," said
Catherine DesRoches of the Morgan Institute, who led the study.
In recent years several initiatives have been
taken to encourage adoption of EHRs. The 2009 American Recovery and
Reinvestment Act authorized approximately $30 billion in grants and
incentives to support EHR implementation.
The researchers analyzed data collected in
a survey sent to COOs of acute care hospitals belonging to the
American Hospital Association. Completed surveys were returned from
almost 3,000 hospitals in the 50 states and District of Columbia.
Respondents were asked whether and to what extent their institutions
had implemented computerized systems for 32 functions –
including medication orders, lab reports, specimen tracking and
Results for hospitals with comprehensive EHR
systems – defined as having 24 functions available in all
clinical units – were compared with those of institutions
with basic systems – 10 functions in at least one major unit
– and those with none. While a few functions were associated
with modest improvements in areas like length of stay and surgical
infection prevention, the differences were small and none were broadly
associated with significant levels of improvement.
"This study has important implications for the
government’s efforts to define ‘meaningful
use’– the federal standard for receiving financial
incentives," said Dr. Ashish K. Jha, senior author of the study, the
Harvard School of Public Health. "Ensuring that hospitals use these
systems in a robust way will be critical to obtaining value from the
large investment that the nation is making in health information
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