The first way that health information technology affects health care is by improving adherence of patients and doctors to guidelines and protocols. This is done by the decision support system, often in the form of computerized reminders, embedded either in electronic health records (EHRs) or computerized provider order-entry systems (CPOE). For instance, adherence to fecal occult blood test (FOBT) for colorectal cancer has been reported to increase from 12 percent to 33 percent (Overhage et al, 1997), following the use of decision support system. Another example is influenza vaccination. Szilagyi et al. (1992) reported a 23% increase in the absolute influenza vaccination rates for eligible patients (30% in the intervention group versus 7% in the control group), as the result of the installation of a computerized database system to generate reminder letter for influenza vaccination to eligible patients.
The second way health information technology affects health care is by facilitating large-scale data integration and analysis. For instance, aggregation of electronic health records can be used to identify adverse drug events and devise interventions to avoid these events. Such approach was shown to reduce the rate of adverse drug events significantly (2.2% in the intervention group versus 7.6% in the control group) (Evans et al., 1992,1993). HIT also enables automated evaluation of quality of care and identification of procedures or tests that are ineffective, for instance, tests with high false positive rates.
The third way that health information technology affects health care is by reducing medical errors. HIT system enables integration of automated decision making tools and knowledge updating tools and reduces errors due to the gap between doctor’s knowledge and the current standard-of-care. The use of EHRs was shown to reduce medical errors by 20-86% and improve correct medication dosing by 12-20% (Chaudhry et al. (2006)).
Since infants and children are at higher risk for serious medication errors, HIT is expected to have major impacts on pediatrics. Fortescue et al. examined medication errors occurring in pediatric units and reported that computerized provider order-entry systems and clinical decision support system (CPOE+CDSS) would prevent 75.8% of harmful errors.
The fourth way that health information technology affects health care is by lowering utilization and provider time. Several studies report a decrease of 8.5-24% in utilization rates due to the use of decision support system at the point of care. Kucher et al. (2005) reported a decrease of 9% in total office visits, at 2 years following the implementation of comprehensive EHRs in Kaiser Permeante health care network. More specifically, primary care visits are reduced by 11% and specialty care visits are decreased by 5%.
1. Basit Chaudhry, Jerome Wang, Shinyi Wu, Margaret Maglione, Walter Mojica, Elizabeth Roth, Sally C. Morton, and Paul G. Shekelle Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care Ann Intern Med 2006; 144: 742-752
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