Friday, January 11, 2008

Does the EHR really help?

Yesterday, I posted a blog that discussed a white paper indicating that the most important causes of hospital errors (leading to death) were: Failure to Rescue, Decubitus Ulcer, and Post-operative Sepsis. Most of the causes of medical error described in the article seemed to have very little to do with hopital information systems or the electronic health record (EHR).

Another interesting article, recently published, is:

Electronic Health Record Use and the Quality of Ambulatory Care in the United States. Jeffrey A. Linder, MD, MPH; Jun Ma, MD, RD, PhD; David W. Bates, MD, MSc; Blackford Middleton, MD, MPH, MSc; Randall S. Stafford, MD, PhD. Arch Intern Med. 2007;167:1400-1405.

In this article , the authors found that "Electronic health records were used in 18% (95% confidence interval [CI], 15%-22%) of the estimated 1.8 billion ambulatory visits (95% CI, 1.7-2.0 billion) in the United States in 2003 and 2004. For 14 of the 17 quality indicators [that the authors examined], there was no significant difference in performance between visits with vs without EHR use."

In the rush to adopt the EHRs in American medical care, it might be worthwhile to think about those conditions for which the EHR may not be a particular benefit, and those conditions for which EHRs may be a disruptive technology carrying extra risk, and those conditions for which rapid adoption of EHRs is greatly beneficial (if not crucial).

In the next few days, I'll try to write additional blogs on this subject.

- Jules Berman
My book, Principles of Big Data: Preparing, Sharing, and Analyzing Complex Information was published in 2013 by Morgan Kaufmann.

I urge you to explore my book. Google books has prepared a generous preview of the book contents.

tags: big data, metadata, data preparation, data analytics, data repurposing, datamining, data mining, disruptive technology, ehr, emr, laboratory information system