Electronic Record-Keeping Alone May Not Boost Health Care

U.S. may be relying too much on a single technology, expert says

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TUESDAY, Jan. 25 (HealthDay News) -- Electronic health records have so far done little to improve the quality of health care in the United States, a new study states.

Researchers from the Stanford University School of Medicine analyzed data on use of electronic records from 2005 through 2007. The data came from a nationwide physician survey that encompassed nearly 250,000 outpatient visits.

Electronic health records (EHR) were used in 30 percent of those visits, with clinical decision support software, which provides treatment advice, in place for 17 percent of all visits.

The study, published online Jan. 24 in the Archives of Internal Medicine, also found that electronic health records were more likely to be used in western states and in group and hospital-affiliated practices than in smaller practices.

"Most studies before ours focused on how single EHR systems work in a few premier academic medical centers, and some of those studies have found significant benefits," study co-author Max Romano said in a Stanford news release.

"Our study takes a different approach: We looked at all non-federal outpatient settings in the United States, from solo private practices to community health centers, to see whether EHRs were having any noticeable impacts in the real world, and we found no significant differences in care quality," said Romano, a former Stanford undergraduate student who is now a medical student at Johns Hopkins.

Dr. Randall Stafford, an associate professor of medicine at the Stanford Prevention Research Center and the study's senior author, said in the news release that electronic health records did not lead to better care because they are "complicated systems used by individuals who have received little formal training, at least until recently."

As a result of this complexity and lack of training, doctors may not have made full use of electronic record-keeping.

"We've shown that electronic health records and clinical decision support don't by themselves improve quality," Stafford said. "If we want improved quality, we have to look at the whole range of issues that affect quality of care and not put all of our hopes on a single technology."

Other factors that have been shown to affect quality of care, he indicated, include patients' access to health care, their health knowledge, doctors' communication skills, the pressures of outpatient practice and whether the payment physicians receive rewards good quality care.

The U.S. government's decision to invest in health-care technology needs to focus more on quality than on simply getting the technology into the marketplace quickly, Stafford said.

More information

The American Health Information Management Association has more about personal health records.

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