Several pieces of recent research suggest that EHRs don't have a payback, aren't liked by many clinicians, and don't appear to impact health outcomes as projected.
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A study of 30 primary care physician practices, published in JAMIA, finds that implementation of an EHR was associated with lower productivity through seeing less patients, but also with higher revenue, because more services, primarily procedures and tests. This may lead to an increase in ROI for an EHR but also implies they are associated with higher health spending.
http://jamia.bmj.com/content/early/2014/08/27/amiajnl-2014-002686.abstractResearch published in Health Affairs explores the question of whether the now-widespread use of electronic medical records is facilitating upcoding by hospitals, leading to higher Medicare reimbursements.
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Research in the Journal of the American Medical Informatics Association studied the Veterans Health Administration electronic medical record system and found that EHRs are associated with frequent patient safety issues, some from poor user actions, but the majority from issues with the software itself.
http://jamia.bmj.com/content/early/2014/05/20/amiajnl-2013-002578A study published in JAMA Internal Medicine finds that meeting meaningful use requirements in regard to seven performance measures for chronic disease care is only slightly associated with improvement on two performance measures, with worse performance on two and no difference in performance on three.
https://archinte.jamanetwork.com/article.aspx?articleid=1860495About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.
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