Ridiculous Study of the Week: EHRs Save Lives
The idea that an electronic health record (EHR) or electronic medical record (EMR) saves lives never occurred to me. I would think that good doctors with good nurses on a good team in a good hospital really did the trick. But what the hell do I know? To a few researchers, however, they found it their mission to place all the importance on the EHRs. This is what they found:
Evidence linking electronic health record (EHR) adoption to better care is mixed. More nuanced measures of adoption, particularly those that capture the common incremental approach of adding functions over time in US hospitals, could help elucidate the relationship between adoption and outcomes. We used data for the period 2008–13 to assess the relationship between EHR adoption and thirty-day mortality rates. We found that baseline adoption was associated with a 0.11-percentage-point higher rate per function. Over time, maturation of the baseline functions was associated with a 0.09-percentage-point reduction in mortality rate per year per function. Each new function adopted in the study period was associated with a 0.21-percentage-point reduction in mortality rate per year per function. We observed effect modification based on size and teaching status, with small and nonteaching hospitals realizing greater gains. These findings suggest that national investment in hospital EHRs should yield improvements in mortality rates, but achieving them will take time.
I cannot find the full study and refuse to pay money for it. I just don’t care enough. I am no statistician, but it is hard to fathom that a .11% or a .09% change in mortality rate means anything. I am also perplexed with the “new function adoption” discovery they found. What does that mean? “Hey, Barbara, I found the a way to copy and paste! Let’s just use that instead of adding any new information?”
Overall, this study just seems ridiculous. It is has no depth. No “aha” discovery. Intuitively, EHRs can be good if they are workable and not overly complicated. Once you mix in quality indicators, absurd layers of security, and fluffed notes for billing then they become a piece of crap. Just my thoughts.
Be well and get one of our t-shirts here
“…particularly those that capture the common incremental approach of adding functions over time in US hospitals…”
What the hell does this gibberish mean?? Seriously, wha does these words together mean?
Yeah, Pat, it’s kind of funny that people who have no problem instantly understanding “idiopathic biliary atresia” or “autoimmune reflex sympathetic dystrophy” can be completely unable to parse a phrase like that, especially when it is putatively within their own field, but you’re right, I have no idea what the hell they’re saying either.
????
My EMR warns me that it cannot tell if there is an interaction between a wheelchair and Tylenol.
EMRs do not allow a physician to see the big picture. I have always imagined my staff asking about sexual activity and the name of their 3rd grade teacher. when the patient is in the midst of ACS. I fear for the newly indoctrinated into our profession.
In the old days, we just didn’t know the patient’s name at worst. Today, I can barely manage a peak over the top of my laptop at them.
The whole person approach from medical school is no match for the mind numbing, spirit killing, knuckle busting keyboard of a bullet point EMR.
Agreed, The local er pulls med lists out of their asses. I have to try and figure out. The resultant stresses are the reason for me retiring as soon as I hit medicare age. Errors propagated by a mouse click. At least in the past, the brain had to be engaged before the pen was moved!
Pharmacists used to call and correct us when the patients specialists changed a drug. Not anymore.
Med lists in EHR is a quagmire of duplications and outdated drugs that are a bitch to fix with the “pull downs”. I tell people to keep track of the meds or we docs and hospitals are going to kill them! The elderly I ask to enlist their families or I do the best I can.
I take the opposite view. EHRs will kill medicine and patients.
More nuanced measures of adoption, particularly those that capture the common incremental approach of adding functions over time in US hospitals, could help elucidate the relationship between adoption and outcomes.
Is there anything more to say? We are steadily creating a language, as Orwell noted, which is unable to say anything precisely. Now, we are automating it!
Each new function adopted in the study period was associated with a 0.21-percentage-point reduction in mortality rate per year per function. We observed effect modification based on size and teaching status, with small and nonteaching hospitals realizing greater gains. These findings suggest that national investment in hospital EHRs should yield improvements in mortality rates, but achieving them will take time.
The ability to find things that interest one is not particularly admirable. Village Idiots in history have been able to find things that are odd, smelly and unspeakable. Now, we give them academic positions and ask them to find things that make them think about other things.
It is no good having thinking machines which talk to those who cannot think. The machines get stupider rather than smarter.
My EHR saves lives every day, such as when it tells me that Advair is contraindicated in cases of asthma, or that amoxicillin is contraindicated in pediatric patients.
Ah, but we are on a new outcome development movement – “Let Nature Take Its Course.” That will minimize medical errors, as there are to be no medical efforts. It is a bold new leap into paleolithic medicine.