Do EMRs Improve the Quality of Healthcare?

January 25, 2011

In a new study in the Archives of Internal Medicine, the hypothesis that electronic medical records would improve quality was not borne out. However, what was not picked up by most news stories about the article was that the data was from 2005-2007, 4 years old during a period of rapid adoption of EMRs. An accompanying editorial titled “Clinical Decision Support and Rich Clinical Repositories: A Symbiotic Relationship, is critical of the report stating, “This lack of effect of CDS [clinical decision support] on provider behavior was surprising given the strong effects previously reported in randomized controlled trials of these systems.” These critics note that most of the guidelines which are more likely to be followed are immunizations rather than medication use which the study focused on. In conclusion, the editorial writers from the National Library of Medicine state, “Only when EHRs carry rich repositories can we expect EHRs to reach their promise and CDS to have measurable effects on a broad range of quality measures at the national level.”

My conclusion is that the use of clinical decision support within EMRs can impact quality on a national level but that early implementation of EMRs may take time to demonstrate this impact.

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