Hospital Computer Systems Lack Economic Benefits

Computerization of hospital facilities does not save them any money or improve administrative efficiency, according to a new study that claims much of the software being written for use in clinics is aimed at administrators, not doctors, nurses, and lab workers.

Researchers at Harvard Medical School (Boston, MA, USA) linked data from an annual survey of computerization at approximately 4,000 hospitals across the United States from 2003 to 2007 with administrative cost data from U.S. Medicare (Baltimore, MD, USA) cost reports and cost and quality data. They then calculated an overall computerization score and three sub-scores, based on 24 individual computer applications, including the use of computerized practitioner order entry and electronic medical records (EMRs). Subsequently, they analyzed whether more computerized hospitals had lower costs of care or administration, or better quality. The researchers also compared hospitals included on a list of the "100 Most Wired” with others.

The results showed that more computerized hospitals had neither overall computerization scores nor subscores that were consistently related to administrative costs, but hospitals that increased computerization faster had more rapid administrative cost increases. Higher overall computerization scores correlated weakly with better quality scores for acute myocardial infarction (MI), but not for heart failure, pneumonia, or a combination of the three conditions. In multivariate analyses, more computerized hospitals had slightly better quality. Hospitals on the "100 Most Wired” list performed no better than others on quality, costs, or administrative costs. The study was published in the November 24, 2009, issue of the American Journal of Medicine.

"Computer systems are built for the accountants and managers and not built to help doctors, nurses and patients,” said lead author associate professor David Himmelstein, M.D., in an interview with Computerworld magazine. "First, you spend $25 million dollars on the system itself and hire anywhere from a couple of dozen to a thousand people to run the system. And for doctors, generally, it increases time they spend inputting data.”

"For 45 years or so, people have been claiming computers are going to save vast amounts of money and that the payoff was just around the corner,” added Dr. Himmelstein. "So the first thing we need to do is stop claiming things there's no evidence for. It's based on vaporware and hasn't been shown to exist or shown to be true.”

Related Links:
Harvard Medical School
U.S. Medicare