Value of the electronic patient record

What are the economic benefits of Electronic Patient Records based on evidence based studies?

Purpose

Analyze the published research studies in paper by Uslu.

Objectives

In light of recent health IT initiatives, conventional paper based patient records limitations are becoming illuminated: stored in physical location, incomplete, illegible, unorganized, high personnel and storage costs. This paper focuses on whether benefits outweigh the costs of Electronic Patient Records (EPR) based on analysis of published studies and explores the evidence based empirical results.

Methods

Published empirical studies on EPR in a hospital environment constitute the basis of this analysis. MEDLINE was searched 1966 to January 2004. Keywords of medical subject headings (MeSH) from NLM included Electronic Patient Record, Benefit, Cost, Cost and Benefit. ‘‘Medical record system, Computerized” was searched. The results were successively combined by AND-conjunction with the other keywords. Total of 20 studies were evaluated. Assessment of study design was based on 9 stages criteria.

Results

All 19 studies from large US based hospitals with the exception of one German study show a direct economic benefit of EPR, from a total of 20 studies. Only one study claims a monetary disadvantage. Out of the 4 studies that considered impact of EPR on quality of care, one study showed a positive impact of quality of care. Top types of cost savings from studies were 1) Administration, 2) Writing/Data Acquisition, 3) Clinical Care, 4) Nursing Staff.

Conclusion

Studies analyzed offer cost benefits of EPRs as well as cost savings in different areas. However, the studies did not offer overall economic assessment from a national point of view. EPRs have potential to improve paper based patient records, to improve quality. However additional studies are needed to better answer the dimensions of quality of care improvements and national economic and overall health quality improvements.

Commentary

The paper has a analysis of 20 studies on economic benefits of EPRs. Evidence is clear and 19 out of 20 studies showed cost savings of EPRs. There are substantial benefits of EPRs. Future studies will hopefully show additional quality care improvements.

References

Uslu AM, Stausberg J. Value of the electronic patient record: An analysis of the literature. J Biomed Inform 2008; 41(4):675-682.

Submitted by: Paul Aneja