From The Editor | October 17, 2012

Recent Studies Show Value Of EHRs

Ken Congdon, Editor In Chief of Health IT Outcomes

By Ken Congdon, Editor In Chief,
Follow Me On Twitter @KenOnHIT

A few weeks ago, I wrote an article titled Health IT Savings Are Not Hype in response to an article that appeared in the Wall Street Journal questioning the value of EHRs to the U.S. healthcare system. It appears I wasn’t the only one with something to say. Since the Wall Street Journal article was published in mid-September, a wave of new studies has emerged that clearly show how EHRs are helping improve patient care and increase physician efficiency.

One such study was released by drchrono, an EHR software vendor, in late September. This study surveyed more than 1,300 physicians across 1,000 small to midsize practices nationwide about their EHR use. According to the study:

  • 75% of physicians said EHRs increased practice efficiency
  • Physicians claimed to save an average of 62 minutes per day using an EHR
  • 57% of respondents have better operations and reduced paperwork due to an EHR
  • Efficiency gains have allowed physicians to see more patients per day, generating an average of more than $150,000 in revenue annually per doctor

Obviously, I look at any EHR research coming from an EHR vendor with a skeptical eye. However, several third-party and provider-based reports touting the positive impact of EHRs surfaced within the same timeframe.

For example, a study by Kaiser Permanente of nearly 170,000 patients with diabetes showed that EHRs improve diabetes control and help doctors pinpoint patients requiring more intensive drug treatment. The Kaiser team evaluated three steps in the care of diabetic patients for the study: 1) whether or not the patient received medication treatment intensifications, 2) whether or not the patient underwent follow-up testing, and 3) whether or not a patient’s blood sugar or lipid levels were affected by the EHR. Kaiser discovered that EHR use was directly linked to significant improvements in each of these areas. In other words, patients who had high blood sugar or cholesterol levels were more likely to receive medication treatment intensification or follow-up testing if the provider was using an EHR.

A separate study published by the Journal of the American Medical Informatics Association (JAMIA) evaluated the affect EHRs have on preventative care for women. Of the providers surveyed, 29.23% had no EHR, 49.34% had minimal EHR, 15.97% had a basic EHR, and 5.46% had a fully functional EHR. The study showed that the breast examination rate for female patients rose in correlation with the providers level of EHR use — 20.27% for providers with no EHR, 34.96% for providers with minimal EHR, 37.21% for basic EHR users, and 44.98% for those with fully functional EHRs. The study also showed similar increases in pelvic examinations Pap tests, chlamydia, cholesterol, and bone mineral density tests.

Another study conducted by New York’s Weill-Cornell Medical Center and published in the Journal of General Internal Medicine (JGIM) compared the performance of 204 primary care physicians who had adopted EHRs with that of 262 doctors who were still using paper records. The study showed that physicians with EHRs provide more recommended preventative and chronic care to patients compared to physicians in the same community who use paper charts. The researchers evaluated these physicians based on nine quality measures including hemoglobin A1c testing in diabetes, breast cancer screening, chlamydia screening, colorectal cancer screening, LDL testing, and nephropathy testing for patients with diabetes. EHR use translated to significantly higher scores in four of the nine measures (A1c testing, breast cancer screening, chlamydia screening, and colorectal cancer screening) and slightly higher scores in other areas.

While I still think it’s too early to measure the true impact EHRs will have on the U.S. healthcare system, it’s encouraging to see the impact these solutions are already having on patient care. This will ultimately be the true measure of success of EHRs.