President George W. Bush has set a goal for all Americans to have electronic medical records by 2014, but a study reported in July by researchers at Stanford and Harvard universities in the
The study, published in the Archives of Internal Medicine and reported by the Reuters news agency, revealed that electronic health records made no difference in 14 of the 17 measures of quality that were assessed. These areas included prescribing recommended antibiotics, counseling diet and exercise for high-risk patients, screening tests and avoiding potentially inappropriate prescriptions for elderly patients. And physicians using electronic systems did worse than their peers with paper records when it came to prescribing statins for patients with high cholesterol.
The electronic systems seemed to offer an ergonomic way to prevent costly medical mistakes, but the Reuters article notes that few studies have evaluated whether the electronic records actually improve the level of care when compared with paper records.
The areas where electronic record keeping shows promise, according to the study, include helping doctors treat patients with depression to avoid prescribing certain tranquilizers and helping to avoid offering urinalysis during general medical exams.
"I think they will be a very important tool, but I think they are not sufficient in and of themselves to improve quality a great deal," said Dr. Randall Stafford of
The Reuters article points out that there is value in the electronic record keeping despite the assessment in the July study. It notes that electronic systems hold the potential for eliminating errors due to bad handwriting and to make it easier for doctors to follow a patient’s care over time. Some systems can also flag dangerous drug combinations, or offer advice about tests or drugs the doctor might prescribe.