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Electronic Health Records Fall Short of Anticipated Results

Kathleen Blanchard's picture
Electronic Health Records

A study from the Rand Corporation shows implementation of electronic medical records in hospitals have, so far, failed to improve patient care, falling short on anticipated improvements in hospital performance.

The findings come from a study that included 2,021 acute care hospitals that revealed implementation of electronic health records did not improve quality of care when compared to hospitals that did not have the technology. The only exception was treatment of patients with heart failure.

The findings, published in the American Journal of Managed Care, provide a first look at the impact of advanced technology for improving quality measures.

Hospitals that use the health information technology stand to gain financially through legislation passed by the federal government in 2009 who may eventually provide $30 billion in assistance to hospitals that invest in electronic health records.

Spencer S. Jones, the study's lead author and an information scientist at RAND wonders if quality measures are adequate. Current tools look at 17 quality measures related to pneumonia, heart failure and heart attack diagnoses.

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Jones says, "Our existing tools are probably not the ones we need going forward to adequately track the nation's investment in health information technology." The study was performed during 2003 to 2007 at a time when the use of basic electronic health records increased from 24 percent in 2003 to nearly 38 percent in 2006.

The anticipation is that hospital care should improve. What the study found were some general improvements in all three areas, but there was no difference compared to hospitals without electronic medical records.

In addition, hospitals with advanced electronic health records had lower performance for heart attack and heart failure treatment, compared to those without electronic health information systems in place. There was no difference among patients treated for pneumonia.

"With the federal government making such a large investment in this technology, we need to develop a new set of quality measures that can be used to establish the impact of electronic health records on quality," Jones said.

The RAND researchers say there may be several reasons for the mixed results. One explanation is less focus on quality measures from hospital staff whose attention may have been turned to adopting electronic health information systems. They also say quality measures may have peaked and there is no more room for improvement, or it may simply be the complexity of health care.

A major difference between the current study and past analyses of whether electronic medical records improve quality of medical care is that performance was measured in a wide range of non-federal acute care facilities. In the past, researchers focused on large teaching hospitals that had adopted electronic health records early on.
Source: RAND Corporation



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