David Brill
Adopting the latest healthcare information technologies can save lives, reduce complications and cut costs, a new report from 41 US hospitals shows.
It is one of the first studies to provide generalizable, empirical evidence that technology actually improves outcomes, the researchers say.
Inpatient mortality dropped by 15 percent in hospitals with the most highly automated notes and record systems. Complication rates were reduced by 16 percent in those with the highest levels of electronic decision support. [Arch Intern Med 2009;169:108-14]
Lead author Dr. Ruben Amarasingham, assistant professor of medicine at the University of Texas Southwestern Medical Center, said that the study “provides good news and caution” as governments worldwide debate healthcare stimulus packages.
The findings were welcomed in Singapore, where the upgrading of electronic systems across the healthcare clusters continues apace (inset).
Dr. Chong Yoke Sin, group chief information officer at SingHealth, said: “This study is reassuring for the people who invest in information technology for hospitals. There is now evidence to prove that it is indeed useful.”
Although happy with progress so far Chong stressed the importance of performing “meticulous” checks to ensure the integrity of new systems.
“When you use any kind of technology you have got to do it right, otherwise you are propagating the wrong faster and more pervasively. If a human being writes a wrong prescription you have only got that one wrong prescription, whereas if technology is not performing correctly it’s systemic,” she said. “At SingHealth we are always improving with constant feedback from clinical staff on the ground, which enables us to review workflow for better efficiency.”
Amarasingham agrees. “Our results suggest that investment in information technology is a necessary part to improving healthcare. But it’s clearly not sufficient – there needs to be a lot of other action taken.
“It has to be done carefully and thoughtfully over a prolonged period of time with careful outcome measures. If [investment] is not accompanied by a deliberative, strategic approach within hospitals and clinics then you may end up with worse systems, or at least a waste of money,” he said.
Over at the National Healthcare Group Mr. Ho Khai Leng, information technology director, said that new technology “improves care” by giving clinicians quicker and more accurate access to medical information. New systems also “facilitate the seamless transfer of patient information between care providers,” he said.
The digitization of x-rays has been particularly successful – cutting turnaround time from 2 or 3 days down to an hour or less, and saving “significant costs” for NHG and patients alike, he said. Tan Tock Seng Hospital alone saved $16,000 on films and chemicals between January and March 2006, following implementation of the project.
Amarasingham and colleagues reviewed data from 167,233 over-50s who were admitted to urban Texas hospitals between December 1 2005 and May 30 2006. They graded hospitals using the Clinical Information Technology Assessment Tool (CITAT), which measures the level of computerization in four clinical areas.
Average patient costs were reduced by US$538 ($816), US$132 ($200) and US$110 ($167) in hospitals with high scores on decision support, CPOE and test results, respectively. Costs were not significantly different within the notes and records domain.
Amarasingham acknowledged a “generational gap” with technology use, but said that all opinions must be considered when implementing new systems.
“If there are physicians who are reluctant or scared of using it then we need to reach out to them and involve them in the process. They are sometimes our best physicians with enormous experience that they can bring to the table,” he said.
It is one of the first studies to provide generalizable, empirical evidence that technology actually improves outcomes, the researchers say.
Inpatient mortality dropped by 15 percent in hospitals with the most highly automated notes and record systems. Complication rates were reduced by 16 percent in those with the highest levels of electronic decision support. [Arch Intern Med 2009;169:108-14]
Lead author Dr. Ruben Amarasingham, assistant professor of medicine at the University of Texas Southwestern Medical Center, said that the study “provides good news and caution” as governments worldwide debate healthcare stimulus packages.
The findings were welcomed in Singapore, where the upgrading of electronic systems across the healthcare clusters continues apace (inset).
Dr. Chong Yoke Sin, group chief information officer at SingHealth, said: “This study is reassuring for the people who invest in information technology for hospitals. There is now evidence to prove that it is indeed useful.”
Although happy with progress so far Chong stressed the importance of performing “meticulous” checks to ensure the integrity of new systems.
“When you use any kind of technology you have got to do it right, otherwise you are propagating the wrong faster and more pervasively. If a human being writes a wrong prescription you have only got that one wrong prescription, whereas if technology is not performing correctly it’s systemic,” she said. “At SingHealth we are always improving with constant feedback from clinical staff on the ground, which enables us to review workflow for better efficiency.”
Amarasingham agrees. “Our results suggest that investment in information technology is a necessary part to improving healthcare. But it’s clearly not sufficient – there needs to be a lot of other action taken.
“It has to be done carefully and thoughtfully over a prolonged period of time with careful outcome measures. If [investment] is not accompanied by a deliberative, strategic approach within hospitals and clinics then you may end up with worse systems, or at least a waste of money,” he said.
Over at the National Healthcare Group Mr. Ho Khai Leng, information technology director, said that new technology “improves care” by giving clinicians quicker and more accurate access to medical information. New systems also “facilitate the seamless transfer of patient information between care providers,” he said.
The digitization of x-rays has been particularly successful – cutting turnaround time from 2 or 3 days down to an hour or less, and saving “significant costs” for NHG and patients alike, he said. Tan Tock Seng Hospital alone saved $16,000 on films and chemicals between January and March 2006, following implementation of the project.
Amarasingham and colleagues reviewed data from 167,233 over-50s who were admitted to urban Texas hospitals between December 1 2005 and May 30 2006. They graded hospitals using the Clinical Information Technology Assessment Tool (CITAT), which measures the level of computerization in four clinical areas.
Average patient costs were reduced by US$538 ($816), US$132 ($200) and US$110 ($167) in hospitals with high scores on decision support, CPOE and test results, respectively. Costs were not significantly different within the notes and records domain.
Amarasingham acknowledged a “generational gap” with technology use, but said that all opinions must be considered when implementing new systems.
“If there are physicians who are reluctant or scared of using it then we need to reach out to them and involve them in the process. They are sometimes our best physicians with enormous experience that they can bring to the table,” he said.
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