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Evidence of Public Value and Public Risk of Electronic Health Records

Posted Oct 30 2008 3:22pm 1 Comment

Dr. Gordon Atherley makes the following Argument in his examination of the Evidence of Public Value and Public Risk of Electronic Health Records:

  1. Electronic health records are a technology new to healthcare and therefore (a) public accountability for large-scale, government initiatives should be assured,and (b) policy decisions about them should require rigorous and sophisticated efforts relative to evidence.
  2. Electronic health records consume resources that are or could be allocated to healthcare service delivery or development, and thus create opportunity costs. Failure to explore evidence adequately or at all (a) constitutes an issue in social justice and (b) is risky to public policy.
  3. If a public policy fails, confidence wanes not only in the overarching system, but also in and among the people and organizations associated with the failed policy.

(Exerpt from article) Of the 17 electronic health record pilots examined, in only three was Bend successful in finding some evidence of cost-effectiveness. Because the positive evidence was “based only on the opinion of those involved … rather than on more detailed evaluation of the impact … it clearly does not amount to a compelling demonstration of the value of electronic heath records in cost terms” (Bend 2004). Bend found that data entry and rigid data structures consume additional time of physicians and other frontline professionals working in a public system bedevilled by shortages of frontline professionals. In Canada, also in 2004, Leonard (2004) arrived at much the same picture in noting little successful adoption of information technology in healthcare because (a) it is difficult to justify when its benefits are insufficiently articulated or accepted; (b) it does not reduce costs; (c) it has not been shown to improve outcomes sufficiently to justify its costs.  Download article - EHR_Atherley.pdf

Are you aware of any convincing evidence that the benefits of electronic health records outweigh the risks? Anecdotally we believe that we are making the correct decision to move towards widespread implementation of EHR/EMR. At times like this it is good to reflect on the directions that we take - even if we are making the right decision(s).

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If you want to find public records, I found a great site that even lets your do county specific searches. I even found Washtenaw County Public Records
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