A number of studies have failed to show demonstrable improvement in patient outcomes with health information technology (HIT) interventions and much has been written about the unintended consequences of HIT.
But HIT may be turning the corner. A recent paper (Harrington 2011) outlining many of the negative papers on HIT noted that the number of such papers seemed to have peaked in 2005 and diminished in recent years. Another (Buntin 2011) showed that 92% of papers on HIT published since 2007 were positive overall.
Yet another (Zlabek 2011) showed some significant improvements in quality, efficiency and costs. After implementation of an inpatient EMR (electronic medical record), medication errors dropped significantly, the number of lab and radiology tests dropped substantially, and transcription costs dropped dramatically. Even more impressively, the gains were made within a year of implementation.
And another (Jayaram 2011) showed that CPOE with clinical decision support and a computer-based error reporting system led to a dramatic reduction in medication errors on behavioral health units.
It’s likely that many of the “kinks” in the system are being worked out and that better design and redesign (both of software and workflows) and more appropriately tailored decision support tools have finally avoided many of the unintended consequences that had reduced the positive impact of EMR’s.
Harrington L, Kennerly D, Johnson C. Safety Issues Related to the Electronic Medical Record (EMR): Synthesis of the Literature from the Last Decade, 2000-2009. Journal of Healthcare Management 2011; 56(1): 31-43
Buntin MB, Burke MF, Hoaglin MC, Blumenthal D. The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results. Health Affairs 2011; 30: 3464-471; doi:10.1377/hlthaff.2011.0178
Zlabek JA, Wickus JW, Mathiason MA. Early cost and safety benefits of an inpatient electronic health record. JAMIA 2011; 18: 169-172 Published Online First: 2 February 2011
Jayaram G, Doyle D, Steinwachs D, Samuels J. Identifying and Reducing Medication Errors in Psychiatry: Creating a Culture of Safety Through the Use of an Adverse Event Reporting Mechanism. Journal of Psychiatric Practice 2011; 17(2): 81-88, March 2011