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Do electronic medical records make hospitals safer?

By Judy Foreman
April 13, 2009
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Q. Do electronic medical records make hospitals safer?

A. A study from Johns Hopkins University supports the argument that they do.

In theory, electronic records are more accessible, readable, and complete, and thus translate into faster, more appropriate treatment, which could save money and lives. With that in mind, researchers led by Dr. Neil R. Powe, director of the school's Welch Center, looked at 167,233 patients in 41 Texas hospitals.

They found that for all medical conditions studied (heart attacks, congestive heart failure, coronary bypass surgery, and pneumonia), a 10 percent increase in use of computerized records corresponded with a 15 percent decrease in death rates. Hospitals in which doctors wrote medication orders online also had 9 percent fewer complications, such as adverse drug reactions, for people with heart attacks, and 55 percent fewer for people undergoing bypass surgery.

Powe estimates that if the results from Texas hold up nationwide, there would be 100,000 fewer hospital deaths per year, with cost savings of $500 to $1,000 per hospitalization.

Not everyone is so positive. The Congressional Budget Office has said some analyses of health informative technology - or HIT, as it is known - may have overstated the financial benefits by focusing on potential, rather than likely, savings.

An editorial accompanying the Johns Hopkins study, published in the Archives of Internal Medicine, said it provides important additional information on the advisability of health information technology, with "impressive" relationships between the technology and better health and cost outcomes. But, cautioned author Dr. David Bates of Brigham and Women's Hospital, the work by the Johns Hopkins team "should be considered circumstantial; there is no way to be certain that the HIT is responsible for the changes observed."

But Bates goes on to say that, at least for large and medium-sized hospitals, "the time is now" for more computerization.

A recent survey published in the New England Journal of Medicine showed that so far only 1.5 percent of US hospitals have a comprehensive electronic-records system. In part, that's because it's expensive to install such systems and train technical support staff.

But once in place, electronic medical records may hold promise for better care.

E-mail health questions to foreman@globe.com.

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