Chaudhry B, Wang J, Wu S, et al.
Impact of health information technology on quality of medical care.
Annals of Internal Medicine 16 May 2006; Volume 144 Issue 10 (early
on-line publication)
http://www.annals.org/cgi/content/full/0000605-200605160-00125v1
Background: Experts consider health information technology key to
improving efficiency and quality of health care.
Purpose: To systematically review evidence on the effect of health
information technology on quality, efficiency, and costs of health care.
Data Sources: The authors systematically searched the English-language
literature indexed in MEDLINE (1995 to January 2004), the Cochrane
Central Register of Controlled Trials, the Cochrane Database of
Abstracts of Reviews of Effects, and the Periodical Abstracts Database.
We also added studies identified by experts up to April 2005.
Study Selection: Descriptive and comparative studies and systematic
reviews of health information technology.
Data Extraction: Two reviewers independently extracted information on
system capabilities, design, effects on quality, system acquisition,
implementation context, and costs.
Data Synthesis: 257 studies met the inclusion criteria. Most studies
addressed decision support systems or electronic health records.
Approximately 25% of the studies were from 4 academic institutions that
implemented internally developed systems; only 9 studies evaluated
multifunctional, commercially developed systems. Three major benefits on
quality were demonstrated: increased adherence to guideline-based care,
enhanced surveillance and monitoring, and decreased medication errors.
The primary domain of improvement was preventive health. The major
efficiency benefit shown was decreased utilization of care. Data on
another efficiency measure, time utilization, were mixed. Empirical cost
data were limited.
Limitations: Available quantitative research was limited and was done by
a small number of institutions. Systems were heterogeneous and sometimes
incompletely described. Available financial and contextual data were
limited.
Conclusions: Four benchmark institutions have demonstrated the efficacy
of health information technologies in improving quality and efficiency.
Whether and how other institutions can achieve similar benefits, and at
what costs, are unclear.
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