Wednesday, November 18, 2015

So It Looks Like There Is Still No Evidence Things Like The PCEHR Make A Difference.

After a major review this appeared recently.

Effects of health information technology on patient outcomes: a systematic review

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First published online: 14 November 2015

Abstract

Objective To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes.
Materials and Methods The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient safety outcomes.
Results Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1 to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%) studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on direct patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computerized provider order entry.
Discussion and Conclusion Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings.


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Here is the link

http://jamia.oxfordjournals.org/content/early/2015/11/13/jamia.ocv138

If you have access this link gets you to the full paper as well

Given that the PCEHR does not have any decision support and is not an inpatient system it looks like there is precious little evidence it is likely to work!

The Government has no idea what it is doing in e-health - other than relying on a 'wish and a prayer'! $1.5B is a lot to pay on trust.

David.

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