One study is not the end of the road

By Jeff Rowe
12:52 PM
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The New England Journal of Medicine has just published a study that compared the differences in health outcomes between paper-based and EHR-based practices, and if all you did was skim the headlines announcing the results you might think all questions surrounding EHRs had finally been put to rest.

“EHRs Beat Paper in Head-to-Head Competition”, proclaimed one article, while another media outlet declared that “Funding Electronic Medical Records Saves Lives”.

Indeed, the study, which looked at quality outcome data for diabetes patients from “seven diverse health care organizations” in Ohio, did unveil some impressive differences between outcomes from paper-based practices and practices that have moved to EHRs.

But as the researchers themselve note, “inferring that EHRs fully account for the observed differences in quality is not warranted, in part because of the participation of exceptional EHR-based organizations, a nonrepresentative sample of paper-based organizations, and inadequate adjustmen t for patient characteristics.”

In other words, it’s a bit too soon for EHR proponents to be declaring “Mission Accomplished.”

It may seem like quibbling to take issue with how the results of one study are treated by the media and HIT advocates, but the fact is that this particular study looked at the treatment of one disease under circumstances which may or may not be representative of the majority of the healthcare sector.

It’s certainly reasonable to expect similar results as the effective use of EHRs spreads across the country, but that expectation of success doesn’t at all mean that issues such as patient privacy and data security, not to mention sustained financial support for the HIT transition, are simply going to evaporate.

In other words, it seems fair to expect a more sober treatment of such a complicated issue from policymakers and observers alike. The results of this particular study are good news indeed, but there are plenty of challenges ahead, and there’s nothing to be gained by jumping to overly optimistic conclusions.