President Obama has pledged $19 billion to encourage physicians and
hospitals to adopt electronic medical records and similar systems. The assumption is that recycling paper-based patient records and turning to more advanced, wirelessly networked electronic records will be more efficient and save money too. But two recent studies by Harvard researchers suggest these systems do
little good in terms of cutting costs or improving patient outcome.
The first study (PDF file) looked at the relationship between computerization and costs at 4,000 hospitals across the U.S. between 2003 and 2007. While the more wired hospitals seemed to offer a slightly higher quality of care, there was little to no effect on efficiency or cost. The study authors propose several possible explanations for the results. While they concede that paperless hospitals could pay off down the road, they warn that choosing the wrong IT system–say one that isn’t customized for medical use–could make hospitals even more costly than they already are.
The other study, which is not yet published, looked at whether EMRs helped hospitals achieve better patient outcomes. According to a recent NYT article, the study by Ashish Jha found that hospitals with the most advanced EMR systems only fulfilled “best practice standards” for heart failure 1.1 percent more than hospitals with “basic” computer records and 1.9% more than hospitals without any sort of computerized records–not much improvement for programs that can cost tens of millions of dollars to implement. (The lead author of the article declined to talk with Fast Company until the research is officially published, and there is no indication of when that will happen.) This is not to say that electronic medical records aren’t the future of health care–clearly, they are. But, just like creating an iPhone app doesn’t necessarily mean instant business success, EMRs aren’t likely to improve health care unless they’re designed well and used the right way.
In the end, electronic medical records and other efforts to
modernize medical computing could benefit from some comparative
effectiveness research. Normally used for comparing medical treatments to establish which ones are the most efficient, the same type of research could help determine why electronic medical records in their current form are not working to their potential.