Information Technology
Project Management

Benefits of Information Technology

This lecture reviews the impact of Electronic Health Records (EHR) and Computerized Physician Order Entry (CPOE) on quality, efficiency and cost of medical care.

Objectives

• Discuss impact of electronic health records
• Discuss impact of physician order entry

Assigned Reading

1. Chaudhry, Basit MD; Wang, Jerome MD; Wu, Shinyi PhD; Maglione, Margaret MPP; Mojica, Walter MD; Roth, Elizabeth MA; Morton, Sally C. PhD; Shekelle, Paul G. MD, PhD Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Annals of Internal Medicine. 144(10):742-752, May 16, 2006. More►

2. The leapfrog Group.  Fact sheet on computer physician order entry. More►

3. Ross Koppel and others.  Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors.  Journal of the American Medical Association, Vol. 293: 10, March 2005 More►

4. Han YY, Carcillo JA, Venkataraman ST, Clark RS, Watson RS, Nguyen TC, Bayir H, Orr RA.  Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system.  Pediatrics. 2005 Dec;116(6):1506-12. Erratum in: Pediatrics. 2006 Feb;117(2):594.  More► Comments►
5. Campbell EM, Sittig DF, Ash JS, Guappone KP, Dykstra RH.  Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc. 2006 Sep-Oct;13(5):547-56. Epub 2006 Jun 23.  Email instructor if you cannot download the full text of this article from your online library.  More►
6. Ash JS, Berg M, Coiera E.  Some unintended consequences of information technology in health care: the nature of patient care information system-related errors.  J Am Med Inform Assoc. 2004 Mar-Apr;11(2):104-12. More►
7. Ash JS, Sittig DF, Poon EG, Guappone K, Campbell E, Dykstra RH.  The Extent and Importance of Unintended Consequences Related to Computerized Provider Order Entry. J Am Med Inform Assoc. 2007 July-August;14(4):415-423.  If you cannot download this article from your library please email the instructor.  More► 
8. Sidorov J It Ain't Necessarily So: The electronic health record and the unlikely prospect Of reducing health care costs. Health Aff (Millwood). 2006 Jul-Aug;25(4):1079-85.  More►  
9. Blumenthal, David; Glaser, John P.  Information Technology Comes to Medicine.  New England Journal of Medicine. 356(24):2527-2534, June 14, 2007.  More►
   Library memberships is required for access to this article.  If you are having difficulty downloading the file, please contact your instructor.  Email►

Presentations

• None are available at this point.

What you know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing about what you have read.  The enclosed assessment is designed to get you to think more about the concepts taught in this session. 

1. What impact might Electronic Health Records have on intensive care units?
2. What evidence is there that medication errors go down after implementation of Electronic Health records
3. Make a complete list of the types of errors introduced after computerized physician order entry.

Please send an email to your instructor with your responses to the above questions.    Make sure that the email subject line includes the course number, topic name and your name, otherwise it will not get to the right place.  If you wish to receive a receipt that the instructor has received your email, you may request the receipt from your email program.  Please respond to all of the questions within the same email.  Do not attach any files.  Keep a copy of all your emails to the instructor till the end of the semester.  Email►

Rapid Analysis

1. Information on this section will be posted by April 9th.

Optional Rapid Analysis

Make a narrated Power Point slides regarding what you have learned about the evidence on impact of EHR on efficiency and quality of care. Video►

Please do not provide opinions but review the evidence presented to you in the above readings.  Prepare your slides as if you are reporting to the CEO of a hospital or clinic thinking through whether they should purchase an EHR.

1. Be brief:  Do not exceed 10 slides or 10 minutes of narration.
2. Cite your work in smaller font on each slide so I can trace your arguments to its source.  Do not present opinions but data.
3. Be clear.  Do not extrapolate from studies done in a clinic to studies in hospitals and vice versa.
4. Be organized.  Give an overview of what you are going to talk about, present your points and make a summary at the end. 
5. Be visual.  Use charts and graphs from your reading and cite your work.

This work can be accomplished with help from a colleague.  Please do not work with the same colleague that you have worked in a previous project.  Once done, post your work on a public web and send the URL to the instructor or provide your work on a compact disk to the instructor.

See review of the evidence on EHRs by students Alex, Meaghan and Shirin:
 

See review by students Bank, Robyn and Ashley: