Sunday, January 2, 2011
The WSJ Health Blog writes:
With the U.S. and the U.K. heading full steam towards electronic medical records and other health IT applications, how much evidence is there that they improve care?
Not a whole lot, according to a review of existing research on the topic published this week by PLoS Medicine. While governments and other proponents are claiming that digitizing health records can save lives and increase efficiency, the review’s “key conclusion is that these claims need to be scrutinized before people invest quite large sums of money in these technologies,” Aziz Sheikh, lead author of the study and a professor of primary care research and development at the Center for Population Health Sciences at the University of Edinburgh, tells the Health Blog.
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.
There probably are benefits to be had from digitizing health processes, says Sheikh, but they are likely more modest than what’s being talked about. For example, access to care may be improved by remote monitoring via email, phone or text messages. And electronic prescribing seems to boost efficiency according to available evidence, Sheikh says, though larger studies with long-term follow-up are necessary to see if those systems save patient lives.
The root of the overenthusiasm for health IT is a “belief that technology equates with modernization equates with benefits,” says Sheikh.
The research does show some “demonstrable improvements in outcomes” at “centers of real excellence where people have developed systems really carefully and they’ve undergone a lot of evaluation and iteration” to be sure they fit with people’s needs, he says. But those systems have been developed over a decade or so, with extensive clinical involvement. Simply dropping a pre-fab system into a hospital will not likely produce the same results, he says.