Hospitals that use a computerized medical-information tool to help doctors make decisions at the point of care have better patient outcomes than those who don’t, according to a new study in the Journal of Hospital Medicine.
Researchers at Harvard University examined data for Medicare beneficiaries at 1,017 hospitals between 2004 and 2006 as the hospitals adopted a clinical-information system called, UptoDate. They compared that with data from 2,305 hospitals that don’t use the system and found that use of the system was an independent predictor of reduced mortality, shorter hospital length of stay, and better performance on widely used hospital quality metrics.
The study was funded by UpToDate, but the researchers say it had no role in the study design or results.
Lead author Thomas Isaac, a physician at Beth Israel Deaconess Medical Center in Boston and instructor at Harvard Medical School, says that the researchers weren’t sure they’d find any association between the information system and the three quality measures. But hospitals saved approximately 372,500 hospital days per year and 11,500 lives over the three-year period, the study found. The hospitals using the system had better quality performance for care provided to heart-attack, heart-failure and pneumonia patients.
The study says typical annual subscription costs for a 100-bed hospital were $10,578, approximately the amount Medicare reimburses for a case of pneumonia without complications.
Hospitals and physicians have been inexorably marching toward adoption of information technology systems, but there hasn’t been universal agreement on their benefits. A study earlier this year reviewing existing research on such system, including decision-support tools and electronic records, found many of the claimed safety and quality benefits weren’t substantiated by research.
Peter A. Bonis, chief medical officer of UpToDate, tells the Health Blog that the study results “provide objective evidence that simply answering questions at the point of care has a measurable impact on the quality and efficiency of care.”
UpToDate President Denise Basow, also a physician, says, “It’s impossible for any physician to know every piece of new medical data that’s released each day and this study suggests that, even if they can’t know it all, having the data at their fingertips can make a significant difference to patients’ lives.”
The company, started in 1989 by a group led by Harvard nephrologist Burton Rose and now owned by Wolters Kluwer Health, says it is used by more than 450,000 clinicians world-wide and by most academic medical centers in the U.S. It relies on 4,800 experts to synthesize medical evidence and create recommendations for a range of diseases and conditions, which it says it updates regularly.