Study: EMRs not always linked to better health care

A new Rand study finds that hospitals with electronic medical records deliver higher-quality care than those without, but those with more advanced record keeping don't demonstrate the same gains.

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The adoption of electronic medical records, or EMRs, in U.S. hospitals has improved the quality of care in only one of three areas studied, and even in that area, the gains are limited, according to new research by the nonprofit Rand published this week in the American Journal of Managed Care.

Researchers analyzed the quality of care at 2,021 hospitals between 2003 and 2007 across three conditions: pneumonia, heart attack, and heart failure. The number of hospitals using either basic or advanced EMRs grew from 24 percent in 2003 to 38 percent in 2006.

Not only did the researchers find no improvement in care when hospitals adopted EMRs for the first two conditions, pneumonia and heart attack, but they also found that the greatest improvements in care they saw were for people with heart failure in hospitals using only basic EMRs; where EMRs were advanced, quality scores actually improved less than at hospitals that did not have them at all.

In other words, when it comes to quality of care, sophisticated EMRs may be delivering little more than pretty bells and whistles. But the researchers admit that more work needs to be done to determine if they are even measuring EMRs' effect on care accurately.

"The lurking question has been whether we are examining the right measures to truly test the effectiveness of health information technology," lead author Spencer Jones said in a statement. "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."

Legislation approved in 2009 could direct upwards of $30 billion in federal aid to hospitals adopting electronic health records. This study serves as something of a wake-up call; it suggests that in order to know whether EMRs are worth the cost, their impact on quality of care must be further investigated.

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About the author

Elizabeth Armstrong Moore is based in Portland, Oregon, and has written for Wired, The Christian Science Monitor, and public radio. Her semi-obscure hobbies include climbing, billiards, board games that take up a lot of space, and piano.

 

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