Monday, February 01, 2010

Yet another study on the impact of EMRs

Early hype about the benefits of the electronic medical record was bolstered by low quality data, unwarranted comparisons with industry and reliance on opinion. Now, despite an increasing body of evidence that such claims are unwarranted, naïve enthusiasm continues. Another large study has been published in the Green Journal. The paper opens with a description of the initial enthusiasm for the EMR:

Enthusiasm for health information technology spans the political spectrum, from Barack Obama to Newt Gingrich. Congress is pouring $19 billion into it. Health reformers of many stripes see computerization as a painless solution to the most vexing health policy problems, allowing simultaneous quality improvement and cost reduction.

But the study findings, like those of previous research, were that the impact of the EMR is somewhere between slim and nothing:

Hospital computerization has not, thus far, achieved savings on clinical or administrative costs.

More computerized hospitals might have a slight quality advantage for some conditions.

No reliable data support claims of cost-savings or dramatic quality improvement from electronic medical records.

Concerning that second point, the slight quality advantage cited refers merely to the adherence to performance measures which, as has been repeatedly shown, is not a surrogate for real quality. It says even less, of course, about patient outcomes. The authors concede that any improvement in performance scores attributable to the EMR may merely reflect facilitation of documentation to make scores look better.

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