boston.com Your Life your connection to The Boston Globe
White Coat Notes: News from the Boston-area medical community
Comments
Send your comments and tips to whitecoat@globe.com
Categories


Blogger
Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Contributors
Boston Globe Health and Science staff:
Scott Allen
Alice Dembner
Carey Goldberg
Liz Kowalczyk
Stephen Smith
Colin Nickerson
Beth Daley
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
 Short White Coat blogger Ishani Ganguli
 Short White Coat blogger Jennifer Srygley
Week of: November 11
Week of: November 4
Week of: October 28
Week of: October 21
Week of: October 14
Week of: October 7

« On the blogs: Beth Israel CEO has some advice for Caritas Christi | Main | 'Prostatempathy' may guide inappropriate PSA test ordering, study says »

Monday, July 9, 2007

Electronic records alone don't improve outpatient care, study says

Electronic health records, championed as a way to improve patient health and safety, don't by themselves lead to better care in doctors' offices, a study shows.

Researchers from Harvard and Stanford found that electronic records made no difference in 14 of 17 measures of quality for outpatient health care, according to today's Archives of Internal Medicine. They examined data from the National Ambulatory Medical Care Survey gathered from visits to doctors in 2003 and 2004.

Two categories showed better performance on recommended care in the 18 percent of visits in which electronic health records were used: not prescribing tranquilizers for depression and not ordering routine urinalysis in general medical exams. But in one area -- prescribing statins for patients with high cholesterol -- physicians using electronic health records performed worse than doctors who didn't have them.

The missing piece is information to guide clinical decisions, co-author Dr. David W. Bates of Harvard Medical School said in an interview last week. Prompts to order tests, prescribe medications or avoid harmful drug interactions can make the records more than just computerized charts, the study said.

"I was surprised," he said. "I expected we would find improvement with the use of electronic health records, especially because there's a lot of evidence that with good decision support, quality measures do improve."

The survey did not ask if doctors were using electronic records with decision support tools, said Bates, who is chief of general internal medicine at Brigham and Women's Hospital. But previous research has shown quality goes up when a physician is reminded to order a lab test to monitor a patient's diabetes, for example. Decision support is most helpful with preventive care and chronic disease management, he said.

"I hope this will emphasize the importance of including good decision support in electronic health records," he said.

Posted by Elizabeth Cooney at 04:00 PM
Sponsored Links