A new RAND Corporation [removed]study[/removed] finds that the use of electronic health records by hospitals across the United States has had only a limited effect on improving the quality of medical care. The study, published by the American Journal of Managed Care, is one of the first to look at a broad set of hospitals to examine the impact that adopting electronic health records has had on the quality of care.
One expected benefit of electronic health records is improved quality of care. Most of the current knowledge about the relationship between health information technology and quality, however, comes from a few hospitals that may not be representative, such as large teaching hospitals or hospitals that were among the first to adopt electronic health records.
Studying 2,021 hospitals—about half the nonfederal acute care hospitals nationally, the researchers determined whether each hospital had electronic records and then examined performance across 17 measures of quality for three common illnesses—heart failure, heart attack, and pneumonia. The period studied spanned 2003 to 2007. The number of hospitals using either basic or advanced electronic health records rose sharply during the period, from 24% in 2003 to nearly 38% in 2006.
The researchers found that hospitals with basic electronic health records demonstrated a significantly higher increase in quality of care for patients being treated for heart failure. Similar gains, however, were not noted among hospitals that upgraded to advanced electronic health records. At hospitals with newly adopted advanced electronic health records, quality scores for heart attack and heart failure improved significantly less than at hospitals that did not have electronic health records. Electronic health records had no impact on the quality care among patients treated for pneumonia.
Researchers say the mixed results may be attributable to the complex nature of health care. Focusing attention on adopting electronic health records may divert staff from focusing on other quality improvement efforts. In addition, performance on existing hospital quality measures may be reaching a ceiling where further improvements in quality are unlikely.
According to the researchers, the findings are part of a growing body of evidence suggesting that new methods should be developed to measure the impact of health information technology on the quality of hospital care. For example, electronic health records are expected to lower the risk of adverse drug interactions, but existing quality measures do not examine the issue.
Use of electronic health records is growing rapidly among hospitals in the United States, spurred by a major federal investment in technology. Legislation approved in 2009 may eventually provide as much as $30 billion in federal aid to hospitals that invest in electronic health records.
Source: Rand Corporation