What Are The Potential Health Benefits Of Electronic Medical Record Systems? (Part 1)

Using Health Information Technology for preventive care

Part 1

Beyond safety, the literature provides little evidence about Electronic Medical Records systems’ effects on health. We must, therefore, hypothesize about both mechanisms and magnitudes of effects. We considered two kinds of interventions intended to keep people healthy (or healthier): disease prevention measures and chronic disease management.
These interventions are key to understanding Health Information Technology’s potential. First, they would exploit important features and capabilities of Electronic Medical Records systems: communication, coordination, measurement, and decision support. Second, they are potentially high-leverage areas for improving health care. Physicians deliver recommended care only about half of the time, and care for patients with chronic illnesses absorbs more than 75 percent of the nation’s health care dollars. Third, evidence from regional health information network (RHIN) demonstrations suggests that these are key applications of Health Information Technology.
Using Health Information Technology for short-term preventive care. Electronic Medical Record systems can integrate evidence-based recommendations for preventive services (such as screening exams) with patient data (such as age, sex, and family history) to identify patients needing specific services. The system can remind providers to offer the service during routine visits and remind patients to schedule care. Reminders to patients generated by Electronic Medical Record systems have been shown to increase patients’ compliance with preventive care recommendations when the reminders are merely interjected into traditional outpatient workflows. More systemic adaptation—for example, by Kaiser Permanente and Group Health Cooperative—appears to achieve greater compliance.
We estimated the effects of influenza and pneumococcal vaccination and screening for breast cancer, cervical cancer, and colorectal cancer, using data about the current compliance rate, the recommended population, and the costs. We assumed that the services are rendered to 100 percent of people not currently complying with the U.S. Preventive Services Task Force recommendation. We also applied the health benefit estimates from the literature to this population (Exhibit 3 ). We conclude that all of these measures, except for pneumococcal vaccination, will increase health care use and spending modestly. But the costs are not large, and the health benefits are significant: for example, 13,000 life-years gained from cervical cancer screening at a cost of $0.1–$0.4 billion.

Richard Hillestad