Study: Electronic records not helping outpatient medicine

Electronic records hold the potential to improve medical care by flagging problems such as drugs that shouldn't be combined, but a study by Stanford and Harvard medical school researchers has concluded that so far they haven't improved the quality of outpatient health care.

The researchers studied a database of 1.8 billion doctor visits in 2003 and 2004 and examined performance on 17 indicators of quality. The results were mediocre, according to Stanford.

"In essence, we found little difference in the quality of care being provided by physicians with electronic health record systems, compared to those without these systems," Dr. Randall Stafford, a Stanford associate professor of medicine and senior author of the research, said in a statement. The research is scheduled for publication Monday in the Archives of Internal Medicine.

The issue isn't necessarily that electronic records don't help make better decisions. For one thing, many systems just transferred previously paper records into electronic form without adding extra abilities such as checking for negative drug interactions. For another, doctors often don't necessarily take advice from an electronic system.

Electronic records didn't make a difference in 14 areas, such as avoiding drugs that could be inappropriate for older patients and prescribing appropriate antibiotics. In two areas, doctors with electronic records systems did better than otherwise, and in one, they did worse, Stanford said.

Update:This posting has been changed to correct the results in the three tests where doctors with the electronic records system did better or worse than those without.

[chpdx]

Backwards

You have the last two points backwards. According to the study doctors with EHRs did significantly better in the two areas and worse in the one area.

[Shankland]

reporter responds: thanks--youre right

Thanks for the note. We've corrected the posting.

The doctors with electronic records systems did better in two areas: not prescribing benzodiazepine tranquilizers for patients with depression and avoiding routine urinalysis during general medical exams. They fared worse in prescribing statins for patients with high cholesterol, according to the study.

[aka_tripleB]

There is still other benefits for electronic records

If anyone has seen the area where people keep records (i.e. patient, employee, criminal) it makes it easier to find the information you're looking for, you're less likely to pull the wrong file when you're trying to add data to someone's file, and it takes up much less space.

Sure there are the typical drawbacks that come with any computer system, but for many organizations the benefits still far outweigh the costs.

[thriftyT]

validity of study?

I'm not convinced that one can draw anything conclusive from
this study.

Also, one of the key benefits of electronic records isn't
addressed: efficiency.

A computer isn't necessarily going to make for better doctors,
but can it make for more efficient hospitals and offices? Can it
save time and money? Yes and Yes.

This study misses a big part of the picture entirely.