Managing Expectations for Electronic Medical Records

Lora Bentley

After all the hype we've heard in recent years about electronic medical records increasing efficiency and quality of care, I bet those pushing for electronic records weren't happy to see the results of a new Stanford University study that were released this week.


According to Reuters, the study revealed that the use of electronic records systems-even those that included "decision support" software for treatment tips-did not necessarily improve quality of care.


Dr. Randall Stafford, who led the study of data from more than 250,000 visits to doctors' offices and other outpatient sites between 2005 and 2007, said:

Across a wide range of quality indicators there was no consistent association between having those electronic tools available and providing better quality of care.

Other studies have reportedly found that decision support tools do improve quality of care, but Stafford indicated such an improvement would take more than new information technology. He encourages physicians, hospitals and regulators alike to be more realistic about their expectations of health care IT.


InformationWeek's Anthony Guerra is also urging people to be more realistic about their expectations for health care IT. Specifically, he points to regulators and others responsible for developing and enforcing the meaningful use requirements that must be met before incentive funds are handed out.


Guerra writes:

As far as I see it, meaningful use is a brakeless train heading for a solid mountain. Some, to be sure, will jump before impact, abandoning the program rather than continuing to throw good money after that spent on a project which will not qualify for reimbursement. Far worse, others will continue to shovel coal into the rickety engine of their organization, pushing the train beyond capacity and hurting patients in an attempt to qualify for monies, ironically, set aside to help them.

Hopefully, the situation is not as bleak as Guerra makes it out to be, but if Stafford's study is accurate rather than an anomaly, health care providers have a long road ahead.

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Add Comment      Leave a comment on this blog post
Jan 29, 2011 3:39 PM Tim Richardson, PT Tim Richardson, PT  says:

I'm not convinced because...

The researchers did not include clinic characteristics under the asumption that quality indicators should be applicable to all patients.

It would be interesting to see a data sample of this size stratified by clinic size, and perhaps by degree of customiztion of the EMR/CDS.

A recent British systematic review found that large academic settings with customized EMR/CDS, committed leadership and continuous quality improvement did achieve better safety, efficiency and guideline adherence.

Smaller clinics and clinicians did not.


I think this just shows that EMR/CDS is not scalable to smaller clinics.


Jan 31, 2011 4:11 PM Mitchell Basch Mitchell Basch  says: in response to Tim Richardson, PT

I had a doctors appointment in a new office the other day. They asked me to come in 15 minutes early to fill out paper work. I came in and as soon as i started filling it out i realized that I couldn't remember anything about my previous medical history, such as the surgeries  underwent and medications i was prescribed in the past to who my doctors were. I can see how beneficial it is to the consumer to own a PHR. Companies not only like Medefile Records would not only benefit people but also save time if ever in a emergency. Doctors would make far less mistakes anytime, or anywhere.

Feb 1, 2011 10:50 AM Angela Schul Angela Schul  says:

Anthony Guerra's critique on the HITECH Act doesn't point out that late EHR adopters will receive penalties starting in 2015 (if the Providers accept Medicare).  In which case, Providers can either "jump on the band wagon" now and acrue between $44,000-$64,000 in federal incentives over the next 5 years, adopt an EHR in 2015 and receive no financial benefits, or never adopt an EHR system and, thus, be subject to financial penalties under Medicare. 

The ultimate goals of meaningful use of an electronic health record are patient engagement, reduction of racial disparities, improved safety, increased efficiency, coordination of care, and improved population health, all of which improve the quality and efficiency of patient care.

Many of the EHRs out there meet and exceed these goals with ease of use for the Provider, many do not.  A "better" study would be to take the top, certified EHR systems out there and test their efficiency.  I know one that would score high and with flying colors.

Angela Schul

MD Practice Solutions



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