Journal addresses, publishes 'next-generation' EHR research

The American Journal of Managed Care has now weighed in on the impact of electronic health records and health IT with a special issue devoted to research on the subject.

The issue is highlighted by an introduction by guest editor and former National Coordinator for Health IT Farzad Mostashari, M.D., now a visiting fellow at the Brookings Institute. Mostashari notes that this latest round of health and payment reform is different because of the new tools and data that EHRs and other health IT offer.

"This issue of AJMC provides many reasons to be hopeful that the combination of changing incentives and new data tools can indeed deliver better care at lower cost," Mostashari writes, although he also points to "warning signs" regarding who might reap the most financial benefits.

Some of research appears to corroborate existing findings or concerns in EHR implementation. For instance, an article by Julia Adler-Milstein and Robert Huckman finds implementation differences caused a disparity in physician practice productivity.

"Increasing EHR use and delegating EHR-related work to support staff do improve clinician productivity; however, doing both gives large practices an additional productivity bump, while there is a loss among small practices," they write. 

Another study finds that medication management, as required by Meaningful Use, does indeed reduce adverse events and saves costs.

Other research finds no definitive answers and called for further investigation. For example, a study on the financial benefits of health IT by Alexander Low concludes that it's unclear whether health IT on its own can reduce general healthcare spending.       

Other topics covered include the evolving vendor market for ambulatory EHRs and the perceived value of health information exchange.

"The body of work presented in the journal is representative of the kind of next-generation HIT studies sorely needed to further our understanding of how to use these technologies effectively" Ashish Jha, M.D. of Harvard's School of Public Health says in the commentary. "It is particularly critical because the adoption of information systems in other industries took decades to pay off. Given the financial burden that our healthcare system places on our society, we don't have decades to wait."

Research published earlier this year in the Journal of the American Medical Association determined that electronic health records, which have long been maligned as disruptive to the patient/physician relationship, can be used to enhance communication and interaction.

To learn more:
- access the special issue