While a series of blog entries recently cite the “Electronic Health Record Adoption and Quality Improvement in US Hospitals” http://www.ajmc.com/supplement/managed-care/2010/AJMC_10dec_HIT/AJMC_10decHIT_Jones_SP64to71 study published in the American Journal of Medical Care’s site in December, there seems to be a disconnect between bloggers on the intent of the study and the scope of its results.
Note the objective of the study was to study the quality improvement of EHR (Electronic Health Record) also known as EMR (Electronic Medical Record) IN HOSPITALS. While the study indicates that EHR’s have a limited effect on quality of health care IN HOSPITALS, its a commonly held belief that when data collected by Primary Care Physicians, specialists, diagnostics and other medical services is well documented and cohesively available to a medical practitioner the practitioner is more aware of history and therefore better able to deliver improved service. The study is limited to hospital environments by its own mandate and its results must therefore be interpreted in context.
Also note that Spencer Jones (first author of the study) has elaborated on issues related to introduction of complex EHR systems and their unintended consequences on quality of health care. A more utopic view is a common EHR/EMR implementation that fades into the background of care and is assumed as a mature deployment of information source on patient’s history. Adoption, especially early adoption can have disruptive effects if deployed as a focus of change rather than its consequence. This concern simply underscores that medical systems require very careful deployment and subsequent training and testing. Imagine giving Radiology a powerful new but dangerous device and not testing that the operators are well trained. In comparison the frequency at which records are referred to in a medical environment requires their use to be second nature to most hospital users.
What needs to be studied in this context is a more holistic use of EMR / EHR from the origin of symptoms to hospital care. Of course what is missing for such a study is the pervasive use of EMR / EHR which would be required to distinguish its effects. Use of this study to diminish the usefulness of EHR/EMRs is misleading statistics at best. Digitizing medical records makes them more readily available and I for one want all my medical providers to have the same and most current information.
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Since 1988 Mark has developed several enterprises from the ground up. He was the president of HIMC, a hotel management company, Vice Chairman of the Research Committee American Hotel & Motel Association and founding member of Lodging Data Center, president of Megainteractive & Telegenisys, Inc. among other companies.