Wednesday, August 15, 2007

Electronic Health Records - Words to the Wise and the Wired: EMRs No Quality Panacea

Three articles – 1) July 8 Archives of Internal Medicine “Electronic Health Records Use and the Quality of Ambulatory Use in the United States;” August 13 AMA News, “EMRs Don’t Quarantine Quality Care,” 3) August 9 NEJM “The Tension between Needing to Improve Care and Knowing How to Do It” – remind us EMRs as indicators and enforcers of quality remain works in progress. In the Archives piece, a study of 50,000 patient records, paper-users did just as well as EMR-users and in the case of appropriate prescriptions for high cholesterol, 14% better.

Two quotations from these articles are worth beating in mind.

1.Jeffrey Linder, MD, assistant professor of medicine, Harvard, “You just can’t take all the paper in doctors’ file cabinets and pour it into the computer and watch quality magically improve.”

2.NEJM authors, “Interventions that appear to be promising on basis of preliminary studies often prove to have no benefit, and those that are beneficial typically result in modest improvement, not monumental breakthroughs.”

1 comment:

Gary M. Levin said...

I agree with this about 75%. Certainly EMR and HIE are only one part of the changes that will occur.