Bad News on E-Health: There’s No Payoff
Sheikh and his colleagues scrutinized 53 reviews of the evidence surrounding technologies including electronic medical records, computerized provider order entry and computerized decision-support systems. The strength of the evidence varied from technology to technology, but in general the review found that “many of the clinical claims made about the most commonly deployed [digital health] technologies cannot be substantiated by the empirical evidence,” the authors write.
Full article on the downside of computerized ordering systems.
Whatchawannabet all the folks cheerleading for EMRs wan’t skip a beat over this study.
I’m not surprised by this result.
I think Health IT has the potential to improve health care productivity and quality. But it will take time to experiment and figure out what works; where it works; and how to re-engineer and improve health care processes to incorporate health IT. This is essentially how IT integration worked in other areas of our economy. Virtually all of the hardware that we used in the 1970s is long gone — as is the software. Most of the operating systems are gone. Microsoft is ubiquitous and MS Office is the norm. FAX machines are obsolete; having been mostly replaced with email. Thirty years ago nobody could have predicted the IT infrastructure that our economy would be using today. So why do advocates of Health IT assume a top-down approach will work for health care? It is not the mere application of information technology that improves productivity. Rather, it is the re-engineering of systems and processes that integrates IT that improves efficiency.
Paul is probably right. It’s a sad state of affairs.
Health IT is the newest fascination for me. On the one hand, it seems like the technology should be there to build a comprehensive, completely-integrated system (after all, Walmart can do it for their 250,000 product ordering). On the other hand, the human body seems so much more complicated. It’s hard to make sense of it all.
I’m not surprised by this result. Electronic records work well where they are part of the provider/supplier business plan. If doctors see the record as essential to the service they are providing, they will use them and they will enhance the product.
Examples of where they work well: walk-in clinics, telephone and email consultation services, concierge doctors, etc.
This boils down to the systems being oversold. The reality is the systems are alternate forms of data entry. What was the policy of prescribing the 2 drugs before the system was installed? My bet there was one, what did it call for, did it ever cause a delay, why was it implemented in the system, etc.? Electronic or paper, it all boils down to data processing and the systems you have in place. There is no doubt in my mind you could run this study on a paper system and find similar flaws. Now if you ever want to do something with all that data you have amassed…
One system is by far superior.