In ambulatory care, it has long been known that introducing a basic EMR for electronic documentation while continuing to perform other tasks on paper can actually make a physician practice less efficient. Now the same trend is emerging in studies of the use of EMRs in emergency rooms and hospitals.
A new paper shows that patients who go to emergency departments (EDs) that have advanced EMRs spend 22 percent less time there, on average, than people who present at EDs that lack EMRs. In the study of 30,000 patient visits to 364 hospitals nationwide, Michael Furukawa of Arizona State University found that EDs with the best EMRs had 13 percent shorter treatment times, 24 percent shorter stays for patients who eventually were admitted to the hospital, and 21 percent shorter stays for those who were treated and then discharged from the ED.
However, the study found that EDs that used only basic EMRs had a 47 percent longer wait time than non-EMR-equipped EDs for patients with urgent or semi-urgent medical issues.
An earlier study by Furukawa and two of his colleagues analyzed medical records of 300 California hospitals that adopted some kind of EMR between 1998 and 2007. Overall, the study showed that EMR usage was associated with lower mortality rates, but not fewer complications or lower costs. However, the study found that as the hospitals implemented the EMRs in a more advanced manner, their results improved, and the researchers postulated that cost savings might increase over time. For example, less money was spent on nurse overtime, possibly because the nurses were documenting care as they provided it rather than waiting until the end of their shifts.