Better care no guarantee with e-health: study

Hospitals that upgrade to electronic medical records may not necessarily have higher-quality medical care, a U.S. study suggests.


The study in this week's online issue of the American Journal of Managed Care focused on a range of hospitals in the U.S., unlike previous research that focused on large teaching hospitals or those that were early adopters of the technology.

For each of the 2,021 hospitals representing about half of the non-federal, acute-care hospitals in the U.S., researchers examined performance across 17 measures for three common illnesses: heart failure, heart attack and pneumonia.

Spencer Jones, an information scientist at RAND, a non-profit research organization, and his co-authors found significantly better care for patients treated for heart failure but not the other two conditions.

Quality scores for heart attack improved no faster at hospitals that adopted basic electronic health records than those that did not, the researchers found after reviewing data from 2003 to 2007.
There was also no impact on quality of care among patients treated for pneumonia.

The scientists offered several possible explanations for the mixed results, such as how adopting the technology may divert staff from other ways of improving quality, or how existing hospital quality measures may rise to a ceiling level and no higher.

"Our results suggest that improving quality scores beyond 91 per cent to 92 per cent for pneumonia and 93 per cent to 94 per cent for [heart attack] may be considerably more challenging than improving quality below those levels," the study's authors wrote.

Researchers are working on new ways to measure how health information technology affects quality of hospital care, just as legislation approved in 2009 could provide up to $30 billion US in federal aid to hospitals that invest in electronic health records.

"Our existing tools are probably not the ones we need, going forward, to adequately track the nation's investment in health information technology," Jones said in a release.

The findings should temper expectations on the pace and magnitude of the effects of health information technology legislation in the U.S., the study's authors concluded.

Read more: http://www.cbc.ca/health/story/2010/12/24/electronic-medical-records-hospitals-quality.html#ixzz19srKz5dQ