Question

A EHR vendor explains that their computer record system improves the quality of care and patient outcomes because they can demonstrate that use of the system results in patient records that are more complete than those of competitors.

Is this a reasonable argument? State your view.

Search for an article published in a peer-reviewed journal that discusses the impact of EHRs on quality of care and/or patient outcomes. Summarize the article reporting the findings. The article must be from a peer-reviewed journal.  

Answer 1

When health care providers have access to complete and accurate information, patients receive better medical care. Electronic health records (EHRs) can improve the ability to diagnose diseases and reduce—even prevent—medical errors, improving patient outcomes.

A national survey of doctors who are ready for meaningful use offers important evidence:

• 94% of providers report that their EHR makes records readily available at point of care.
• 88% report that their EHR produces clinical benefits for the practice.
• 75% of providers report that their EHR allows them to deliver better patient care.

EHRs can aid in diagnosis

With EHRs, providers can have reliable access to a patient's complete health information. This comprehensive picture can help providers diagnose patients' problems sooner.

EHRs can reduce errors, improve patient safety, and support better patient outcomes

• A qualified EHR not only keeps a record of a patient's medications or allergies, it also automatically checks for problems whenever a new medication is prescribed and alerts the clinician to potential conflicts.
• Information gathered by a primary care provider and recorded in an EHR tells a clinician in the emergency department about a patient's life-threatening allergy, and emergency staff can adjust care appropriately, even if the patient is unconscious.
• EHRs can expose potential safety problems when they occur, helping providers avoid more serious consequences for patients and leading to better patient outcomes.
• EHRs can help providers quickly and systematically identify and correct operational problems. In a paper-based setting, identifying such problems is much more difficult, and correcting them can take years.
• EHRs can improve public health outcomes

• EHRs can also have beneficial effects on the health of groups of patients.

  Providers who have electronic health information about the entire population of patients they serve can look more meaningfully at the needs of patients who:

• Suffer from a specific condition
• Are eligible for specific preventive measures
• Are currently taking specific medications

• This EHR function helps providers identify and work with patients to manage specific risk factors or combinations of risk factors to improve patient outcomes.

  For example, providers might wish to identify:

• How many patients with hypertension have their blood pressure under control
• How many patients with diabetes have their blood sugar measurements in the target range and have had appropriate screening tests

• This EHR function also can detect patterns of potentially related adverse events and enable at-risk patients to be notified quickly.

• ----- So The Vendor argument is reasonable that their computer record system improves the quality of care and patient outcomes because they can demonstrate that use of the system results in patient records that are more complete than those of competitors

PEER-REVIEWED JOURNAL:

“Use of Information Technology to Improve the Quality of Health Care in the United States”

----- Eduardo Ortiz, MD, MPH and Carolyn M Clancy, MD, Director

In 1969, when the Internet was known as the DARPA net and the World Wide Web was nothing more than a glint in a creative student's mind, the Agency for Healthcare Research and Quality funded its first project in medical informatics. Since then, the Agency has continued to support research and development projects in the use of information technology to improve health care, awarding $250 million dollars to fund more than 150 projects in medical informatics. Today, the Agency is still blazing this technology trail with projects that seek to develop the knowledge and tools needed to improve the quality of care in the U.S. health care system.

Health care has lagged far behind many other industries in harnessing the capabilities of IT to improve services, knowledge, communication, outcomes, quality, and efficiency. Given the complexity of modern medicine, it is inevitable that IT will play an ever increasing role in improving health care quality. As noted by the IOM's Committee on Quality Health Care in America, “Information technology must play a central role in the redesign of the health care system if a substantial improvement in quality is to be achieved over the coming decade.” To make significant progress, a major re-engineering of the health care delivery system is needed, which requires changes in technical, sociological, cultural, educational, financial, and other important factors.

Research is needed to:

• Evaluate the role of IT in improving clinical decision making, information management, communication, costs, and access to care;
• Assess barriers to successful implementation of proven IT, as well as strategies to overcome these barriers so that all patients and providers have access to technologies that can improve safety and quality of care;
• Generate solutions to eliminate the digital divide;
• Document the costs and resources associated with adopting and maintaining proven IT applications; and
• Evaluate transferability of IT solutions to other health care settings