Electronic Health Records: Going Digital May Not Improve U.S. Patient Care
Electronic health records -- touted by the White House as a key way to improve healthcare in the United States -- may actually do little to improve quality, U.S. researchers said on Monday.
A team from Stanford University in California analyzed nationwide survey data from more than 250,000 visits to physicians' offices and other outpatient settings between 2005 and 2007.
They found electronic health records did little to improve quality, even when there was "decision support" software that gives doctors tips on how best to treat individual patients.
"Across a wide range of quality indicators there was no consistent association between having those electronic tools available and providing better quality of care," said Dr. Randall Stafford of Stanford, whose study appears in the Archives of Internal Medicine.
Electronic health records systems that include this software have been shown in other studies to significantly improve health quality.
President Barack Obama has made using information technology a central plank in his plan to cut costs out of the U.S. healthcare system, offering up to $27 billion in government funds aimed at speeding the switch to electronic medical records.
The push is largely based on the assumption that moving to electronic from paper records will improve communication and reduce medical errors. But that may not be so.
In a prior study, Stafford's team showed that simply putting paper records into a digital format did little to improve care. In the new study, the team looked at whether adding decision support tools helped.
The tools remind doctors of guidelines for treating specific conditions. For example, they might remind a doctor to order a specific test, or a specific antibiotic.
But the software tools did not significantly improve quality of care, Stafford said. He said the study suggests that improving health quality will take more than just adding information technology to the mix.
"We need to be more realistic about what to expect from electronic health records," Stafford said in a telephone interview.
"I believe this study suggests that it is naive to believe that the simple presence of an electronic health record or even these systems with more advanced functionality will by themselves change the quality of care," he said.
In a commentary in the same journal, Drs. Clement McDonald and Swapna Abhyankar of the National Institutes of Health said Stafford's findings were "dismal."
They said other studies have found well-implemented decision support programs have been shown to improve care, and it may be that the systems in the study were immature, and better training would improve the outcome.
Stafford said stimulus funding to standardize medical records may improve what he said is now a patchwork of systems.
Health information technology companies include Cerner Corp, McKesson Corp and Quality Systems Inc, as well as larger technology companies such as General Electric's GE Healthcare unit, Siemens, Microsoft Corp and Google Inc.
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