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EHRs Beat Paper in Head-to-Head Competition

Gienna Shaw, for HealthLeaders Media, September 6, 2011
Among the findings:
  • Nearly 51% of patients in EHR practices received care that met all four of the endorsed standards, compared to just 7% of patients at paper-based practices.
  • Nearly 44% of patients in EHR practices met at least four of five outcome standards, compared to about 16% of patients at paper-based practices.
  • After accounting for patient differences, EHR practices had annual improvements in care that were 10% greater than paper-based practices, as well as 4% greater annual improvements in outcomes.

Furthermore, it made no difference whether patients were insured by commercial payers, Medicare, Medicaid, or even if they were uninsured—all showed better results in standards of care and outcomes.

“Some of the rather dramatic differences that we’re showing are a function of sharing across systems and best practices with regard to common conditions and common metrics that we’ve all agreed to attack,” Greater Health Director Randall Cebul, MD, the study’s lead author, told HealthLeaders Media.

“There’s a lot of coaching that goes on. We say we share ideas and compete on execution. Electronic Health Records are simply tools. And the master craftsman will have a workbench with all the tools on it but knows how to use them and uses them in the right circumstances,” said Cebul, who is also a medical professor at Case Western Reserve University and practices at The MetroHealth System—both organizations are members of Better Health Greater Cleveland. “We are training one another in what the tricks of the trade are, in order to do better on the kinds of things that in an increasingly busy primary care practice could be overlooked.”

The study should pave the way for similar projects, said David Kaelber, MD, MetroHealth’s chief medical informatics officer, in an interview. “I hope that this is one indication that we’re really getting to the tipping point.

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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.