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EHRs Beat Paper in Head-to-Head Competition

Gienna Shaw, for HealthLeaders Media, September 6, 2011

Electronic health records (EHRs) show promise to improve quality of care and patient outcomes—that’s why the federal government is investing billions of dollars in them. But data to quantify that potential has been inconclusive and sometimes controversial. Authors of a new study, published last week in the New England Journal of Medicine, say they are among the first to offer hard evidence that in a head-to-head competition, electronic records beat paper.

The researchers tracked quality measures and outcomes for more than 27,000 Cleveland-area adults with diabetes and found that those who were treated at physician practices using EHRs enjoyed substantially better outcomes than those who were treated by doctors relying on paper records.

The more than 500 primary care physicians in 46 practices who took part in the study are all members of Better Health Greater Cleveland, a nonprofit healthcare alliance made up of providers, health plans, employers, and government agencies focused on improving the health of chronic disease patients in Northeast Ohio.

Researchers looked at four national quality standards for care:

  1. timely measurements of blood sugar,
  2. management of kidney problems,
  3. eye examinations,
  4. vaccinations for pneumonia

Outcome measures included meeting national benchmarks for blood sugar, blood pressure, and cholesterol control, as well as more patient-driven actions such as achieving a non-obese Body Mass Index and avoiding tobacco use.

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2 comments on "EHRs Beat Paper in Head-to-Head Competition"


A Davis (9/14/2011 at 1:06 PM)
While the paper does demonstrate mild improvements in patient outcomes, it raises as many questions as it answers. Quality ultimately relates to outcomes, but there is a strong argument that it also relates to costs. If the EMR has caused treatments and, presumably their related costs, to increase by 41%, but have improved outcomes by only 4%, there is a strong suggestion that EMRs are, in fact, detrimental to quality, and this analysis ignores the additional cost of the purchase, implementation and use of the EMR itself, as well as the opportunity costs of taking on what is likely the biggest single budget expansion, for IT implementation, in any given hospital.. I expect that we will see additional articles in the future demonstrating improvements in outcomes associated with EMR use, but I question whether these improvements are affordable in the current context of constraining costs. Given that the outcomes improvements are only slightly better than marginal, in the economic sense, it seems that a sense of caution may be in order.

laura stenger (9/13/2011 at 10:22 AM)
The study on electronic record keeping is very impressive. It is imperative that the patient's health information is not shared to the detriment of the individual patient-insurance denied because of "conditions" by insurance carriers (I am aware that the "new health care bill-law" is supposed to prevent this but the health care legislation will be shaped according to the wants of insurance companies, and providers to bring in more money?because of after the fact lobbing.