Hospital IT — who’d have thought such a dry topic would be so frequently in the news? Because it is a key aspect of both the economic stimulus plan and health care reform, we’ve heard an awful lot lately about electronic medical records and the like. Most of this is not terribly interesting or relevant to us regular folks, but a recent report that linked a hospital’s use of IT with an improvement in patient outcome piqued my interest.
A frequent objection to spending huge sums on healthcare IT is that it hasn’t yet proven to be beneficial. Now a new study provides evidence that it is — but there’s a big “but” to the story. Research conducted by Ruben Amarasingham, MD, MBA, the associate chief of medicine at Parkland Health & Hospital System in Texas and an assistant professor of internal/general medicine at UT Southwestern Medical School in Dallas, examined the use of clinical IT at 41 hospitals. Researchers asked doctors to respond to detailed questions about the degree of automation of four areas: notes and records… test results… order entry… and decision support. They then compared the answers with the rates of inpatient death, complications, costs and length of stay for 167,233 patients older than 50 who were admitted for a variety of conditions during the same period of time.
They found an across-the-board improvement and lower overall costs in the hospitals where the healthcare IT systems had been installed and providers were using them regularly.
The problem is — and even Dr. Amarasingham, the study’s lead researcher, agrees — simply saying “Everyone should be doing this!” is jumping the gun.
Since this is an initial study, it’s clear that more research needs to be done, but the major issue is that implementing and transitioning to these high-tech systems is a long, costly and arduous process. “It can take five to 10 years of advance planning to build a good understanding with physicians and nurses in each institution and also to develop an environment that places a value on the new system,” Dr. Amarasingham explained, noting that an information system is far likelier to bring better outcomes when introduced in a supportive environment.
There are many obstacles to overcome. New privacy rules and safeguards may be required for an institution, since the technology can easily transmit large amounts of private information anywhere, within seconds. There are currently no basic standards for electronic medical records, which means that different hospitals may not be easily able to share information. Also, as is often the case, these systems are not only costly to purchase, but they require additional investment in installation, training and maintenance. These practical matters must be resolved before widespread adoption is realistic.
It may seem that none of this means all that much to us consumers, at least in the near future. But, as Dr. Amarasingham points out, electronic medical records are a near-certainty when you imagine the healthcare system 20 years from now. Interested or not, we should pay attention to the dialogue regarding computerized health records since sooner or later, opting out won’t be an option.
