Monday, December 07, 2009

Harvard: Computers in Hospitals Do Not Reduce Administrative or Overall Costs

ResearchBlogging.orgHarvard researchers recently released the study Hospital Computing and the Costs and Quality of Care: A National Study, which examined computerization’s cost and quality impacts at 4,000 hospitals in the U.S over a four-year period.

The researchers concluded that the immense cost of installing and running hospital IT systems is greater than any expected cost savings. Much of the software being written for use in clinics is aimed at administrators, not doctors, nurses and lab workers. Additionally, as currently implemented, hospital computing might modestly improve process measures of quality but does not reduce administrative or overall costs.

The researchers also found no reliable data support claims of cost savings or dramatic quality improvement from electronic medical records.

The researchers did acknowledge that the modest quality advantages associated with computerization were difficult to interpret since the quality scores reflect processes of care rather than outcomes. Access to more information technology may merely improve scores without actually improving care by facilitating documentation of allowable exceptions.

From the paper:
"We used a variety of analytic strategies to search for evidence that computerization might be cost-saving. In cross-sectional analyses, we examined whether more computerized hospitals had lower costs or more efficient administration in any of the 5 years. We also looked for lagged effects, that is, whether cost-savings might emerge after the implementation of computerized systems. We looked for subgroups of computer applications, as well as individual applications, that might result in savings. None of these hypotheses were borne out. Even the select group of hospitals at the cutting edge of computerization showed neither cost nor efficiency advantages. Our longitudinal analysis suggests that computerization may actually increase administrative costs, at least in the near term."
Himmelstein, D., Wright, A., & Woolhandler, S. (2009). Hospital Computing and the Costs and Quality of Care: A National Study The American Journal of Medicine DOI: 10.1016/j.amjmed.2009.09.004 Sphere: Related Content


Anonymous said...

I think that "at least in the near term" may be the important item here. From a patient perspective, I think the computer systems I have interactions with still need work. I have certainly logged an expensive amount of "I need a human on the help line please" time in attempts to access information. And if I had followed the instructions of my online appointment reminder and showed up at the gastroenterologist's office at 8:30 rather than at 7 the hospital where my colonoscopy was to take place I would have wasted the time of an entire diagnostic team.

I do hope that the analytical software, such as that apparently used with my mammogram, are working well. But if the software had succeeded in finding something suspicious not perceivable by the human eye, that would have resulted in even more expense.

Anonymous said...

I recently spent five days in a very new, self-proclaimed excellent hospital in Omaha NE. I could have told the researchers this for free, after watching nurses struggle with computers on wheels that they had to roll from room to room, then try to locate and update the right records while protecting the visibility of the screen from others in the small and crowded room.