[Med-privacy] EMR study

[peter marshall]

URL: http://www.msnbc.msn.com/id/19684970/

Electronic health records don't aid patient care

Study of 1.8 billion doctor visits showed no real advantage over paper
files

Reuters
July 9, 2007

CHICAGO - Electronic health records touted by policymakers as a way to
improve the quality of health care failed to boost care delivered in
routine doctor visits, U.S. researchers said on Monday.

Of 17 measures of quality assessed, electronic health records made no
difference in 14 measures, according to a study published in the 
Archives
of Internal Medicine.

The study by researchers at Stanford and Harvard Universities was based 
on
a survey of 1.8 billion physician visits in 2003 and 2004. Electronic
health records were used in 18 percent of them.

In two areas, better quality was associated with electronic records, 
while
worse quality was found in one area, they said.

Many experts believe electronic records can help prevent costly medical
mistakes, but few studies have evaluated whether the records actually
improve the level of care when compared with paper records.

"Our findings were a bit of a surprise. We did expect practices (with
electronic medical records) would have better quality of care," said Dr.
Randall Stafford of Stanford University. "They really performed about 
the
same," he said in a telephone interview.

The 14 quality indicators for which electronic records made no 
significant
difference included such factors as prescribing recommended antibiotics;
diet and exercise counseling for high-risk adults; screening tests; and
avoiding potentially inappropriate prescriptions for elderly patients.

The records seemed to help doctors treating patients with depression to
avoid prescribing certain tranquilizers. They also helped to avoid
offering urinalysis during general medical exams.

But when it came to prescribing statins for patients with high
cholesterol, physicians using electronic systems did worse than their
peers with paper records.

Electronic health records promise to eliminate errors due to bad
handwriting and make it easier for doctors to follow a patient's care 
over
time.

Some systems can also flag dangerous drug combinations, or offer advice
about tests or drugs the doctor might prescribe.

President George W. Bush has set a goal for all Americans to have
electronic medical records by 2014.

"I think they will be a very important tool, but I think they are not
sufficient in and of themselves to improve quality a great deal," 
Stafford
said.