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Home / News & IndustryManaged Care Insight and Analysis
Updated: February 15, 2011
Bloom May 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 discharge summaries.

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 technology."

Address: Morgan Institute for Health Policy, 50 Staniford Street, 9th Floor, Suite 901, Boston, MA 02114; (617) 724-4744, www.instituteforhealthpolicy.org.


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