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This article is from the In-Depth Report Modernizing Medicine: Health Care in the Information Age

Fewer deaths in hospitals with computerized records

Don't underestimate the value of good bookkeeping. A new study says that your chance of dying and suffering complications is lower in hospitals and clinics that computerize patient charts and drug orders.

There were 15 percent fewer deaths, and patients treated for heart attacks, congestive heart failure or pneumonia or who had coronary bypass surgery were 16 percent less likely to suffer complications in hospitals that kept records in a centralized computer system, according to research published in this week's Archives of Internal Medicine. The findings were based on the records of 167,233 patients aged 50 and older at 72 hospitals in Texas and on doctor ratings of the information technology at those facilities.

The results held even after researchers (from the University of Texas Southwestern Medical Center, Johns Hopkins School of Medicine and the University of Maryland) controlled for the seriousness of conditions and whether a hospital was an academic center or a cash-strapped "safety-net" facility for the indigent.

Automated systems have varying degrees of bells and whistles, and may be accessible to docs on PCs or bedside desktops. Depending on how sophisticated the system is, it may computerize patients' medical histories, including conditions they suffer from, who has cared for them and what medicines they're currently taking or had allergic reactions to in the past. It may also allow physicians to send prescriptions electronically to hospital pharmacies and get outside input on how to treat a patient using databases of medical research and other docs' expertise. That information may be fragmented at hospitals without the technology, says study co-author Ruben Amarasingham, associate chief of medicine at Parkland Health & Hospital System in Dallas.

"Care of a patient in today’s modern hospital is very complex – there are so many different actors. What information systems do is coordinate that care," Amarasingham says, giving doctors and nurses "all the notes and thought processes at [their] fingertips.

"Because the system is watching out for the patient and the physician, it may be able to point out things not otherwise noticed – changes in lab values, vital signs, drug interaction," he tells ScientificAmerican.com. "That information helps a physician do a better job."

Researchers also found that the cost of care was lower at hospitals with automated systems, ranging from $110 to $538 less per patient. President Obama suggested during his inaugural address that more technology would improve the quality of health care and lower its cost — an argument some dispute. The president met today with congressional Republicans to try to get them on board on the American Recovery and Reinvestment Act, a stimulus package that, among other things, calls for $20 billion in federal monies to computerize health records.

Just 20 percent to 25 percent of U.S. hospitals automate medical records, according to a 2005 RAND Corp. report. Why aren't more wired?

Cost is a major reason: Systems can come with $3 million to $75 million price tags, according to David Bates, medical director of clinical and quality analysis for information systems at Partners HealthCare System, Inc., in Boston. In addition, the systems can take years to put in place, and hospitals have to make sure staff are on board. "If you put in a system most don’t agree with, you’ll have a failure," Amarasingham says.

He adds that it's "shocking" that so few hospitals are computerized today "when we're in the Google era and everything is automated."

Image © iStockphoto/Sam Sefton

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