Study: EMRs with decision support improve patient monitoring, not outcomes

Electronic medical records linked with clinical decision support technology don't necessarily improve patient outcomes, a study recently published in the Archives of Internal Medicine finds.

Published Oct. 24, the study analyzes the use of a vascular tracking and decision support system linked to EMRs used by primary care practices in Ontario, Canada. The decision support system tracked patients' body mass index, blood pressure and cholesterol levels, as well as other risk factors. It also included personally tailored electronic risk monitoring and treatment advice between physicians and patients. The linkage led to increased monitoring of the patients' risk factors, but didn't improve their risk factor profiles, according to the study.

"Computerized decision support systems [CDSSs] linked with electronic medical records are promoted as an effective means of improving patient care. However...no consistent evidence of an effect on patient outcomes has been found," the authors said.

Although the study is based on data from 2005, the results remain relevant, write Drs. Randall Stafford and Max Romano of the Stanford (Calif.) Prevention Research Center in an accompanying commentary. Stafford and Romano argue that the issue at hand is less about technology and the linkage of the EMRs with CDSSs, and more about the fact that it takes more than computer technology to improve risk factor management. The study's authors suggest that there also should be better coordination between different providers and patients, as well as partnerships with public health authorities, to encourage healthier lifestyles.

Another study published in the Archives of Internal earlier this year also determined that EMRs linked to CDSSs by themselves did not improve patient care; of 20 quality indicators studied, only one, diet counseling in high-risk adults, showed significantly better patient outcomes.

To learn more:
- read this MedPage Today article
- here's the study's abstract
- check out the abstract from the earlier study

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