August 27, 2007
Electronic Health Records Don’t Aid Patient Care
Written by: John
From MSNBC:
Electronic health records don’t aid patient care – MSNBC (Reuters)
Electronic health records — touted by policymakers as a way to improve the quality of health care — failed to boost care delivered in routine doctor visits, U.S. researchers said on Monday. Of 17 measures of quality assessed, electronic health records made no difference in 14 measures, according to a study published in the Archives of Internal Medicine. The study by researchers at Stanford and Harvard Universities was based on a survey of 1.8 billion physician visits in 2003 and 2004. Electronic health records were used in 18% of them. In 2 areas, better quality was associated with electronic records, while worse quality was found in one area, they said. Many experts believe electronic records can help prevent costly medical mistakes, but few studies have evaluated whether the records actually improve the level of care when compared with paper records. “Our findings were a bit of a surprise. We did expect practices (with electronic medical records) would have better quality of care,” said Dr. Randall Stafford of Stanford University. “They really performed about the same,” he said in a telephone interview.
Who said that EMRs were about increasing patients’ care? Ok, that looks nice for government work and it’s a great theory about saving lives. However, most of the EMR sales presentations I’ve seen talk about the bottom line. Sure, if I can cover my bottom line, then it’s great if I can offer better care also. However, I would guess that for 90% of the people choosing an EMR 90% of the decision is about dollars and cents.
Granted were not looking at all the details of this study. It would be interesting to take a look at how they quantified quality of care. That sounds like a rather subjective measure to me. I’d also be very interested to see how long most of the doctors in the study had been using an EHR. I can certainly see how at the beginning of an EHR implementation the patient care could be less than with paper. It takes time to mold a system and to implement all of the features that make an EHR work efficiently. However, once implemented a whole new world of patient care comes into focus.
What an EMR can eventually do for you is more interesting and powerful than the immediate impact of implementing an EMR.
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3 responses to "Electronic Health Records Don’t Aid Patient Care"
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I would like to see the stats on this one. I can’t help but believe electronic health records would streamlines the clinician’s workflow and generate a complete record of a clinical patient encounter. America is so far behind in EMR training and use that maybe those using the system were more comfortable with the paper system.
I think the key I’ve seen is that if a doctor is a mess before they have an electronic medical record system, then they’ll still be a mess with an electronic medical record system. Each takes discipline to manage, organize and chart effectively.
However, the added problem that an EMR can have is that many people don’t want to put forth the effort to make the EMR work for them. Instead, they just moan and complain about why the EMR isn’t as good as the paper system.
Sure, a car isn’t as good as a horse, because a horse can go into tight places. However, no one is wishing that we were riding horses around still.
I’d also like to see the full article. It takes a lot of work and time to make an EMR efficient. Resistance to change is inevitable and EMRs totally change the way in which clinicians practice. Work flow is initially interrupted by the implementation of an EMR, but the practice WILL become more efficient if the individuals embrace the technology. The comparison should be ONLY with the 18% of offices who implemented the EMR… did the practice improve after staff had time to adapt? I don’t think we’re addressing the issue with this research. Anyhow, the bottom line is EMRs improve patient safety!