Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs

Hillestad, Richard; Bigelow, James H.; Bower, Anthony G.; Girosi, Federico; Meili, Robin; Scoville, Richard; Taylor, Roger S.

doi:10.1377/hlthaff.24.5.1103

Cited by 1,351 publications

(867 citation statements)

References 11 publications

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“…Yet, three of the top four challenges reported by VA PC directors nationally were focused on clinical informatics, with almost three out of four reporting clinical informatics as a moderate-extreme challenge across facility types, sizes, regions, and urban/ rural locations. Outside the VA, great hope has been placed in the potential of health information technology (HIT), especially EMRs, to enable, if not drive, improvements in quality, efficiency, safety 22,23 and cost reductions, 22,24 and as an essential tool in day-to-day PCMH functioning, if not one of its core principles. 22,25,26 Green has further identified HIT as a key strategy for helping to alleviate the PC physician shortage.…”

Section: Discussionmentioning

confidence: 99%

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

et al. 2014

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“…Concerning the medical domain, different works have emerged which discuss treatment recommendation (Guyatt, Sinclair, Cook, & Glasziou, 1999), as well as those which analyze decision support systems in order to reduce clinical mis takes (Bates et al, 2001). Further efforts explain the benefits of the application of such systems (Hillestad et al, 2005;Kawamoto, Houlihan, Balas, & Lobach, 2005), from a theoretical perspective.…”

Section: Related Workmentioning

confidence: 99%

ODDIN: Ontology-driven differential diagnosis based on logical inference and probabilistic refinements

García-Crespo

Rodríguez

Mencke

et al. 2010

Expert Systems with Applications

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a b s t r a c tMedical differential diagnosis (ddx) is based on the estimation of multiple distinct parameters in order to determine the most probable diagnosis. Building an intelligent medical differential diagnosis system implies using a number of knowledge based technologies which avoid ambiguity, such as ontologies rep resenting specific structured information, but also strategies such as computation of probabilities of var ious factors and logical inference, whose combination outperforms similar approaches. This paper presents ODDIN, an ontology driven medical diagnosis system which applies the aforementioned strat egies. The architecture and proof of concept implementation is described, and results of the evaluation are discussed.

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“…The Agency for Healthcare Research and Quality allocated $60 million in 2004 to promote research and demonstrations to advance IT use for care improvement. 6,17 Similarly, the Food and Drug Administration proposed new regulations for bar coding medications to potentially reduce medication errors.…”

Section: Current It Implementation Trendsmentioning

confidence: 99%

Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice

2006

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The U.S. health care system is one of the world's most advanced systems. Yet, the health care system suffers from unexplained practice variations, major gaps between evidence and practice, and suboptimal quality. Although information processing, communication, and management are key to health care delivery and considerable evidence links information/communication technology (IT) to improvements in patient safety and quality of care, the health care system has a longstanding gap in its investment. In the Crossing the Quality Chasm and Building a Better Delivery System reports, The Institute of Medicine and National Academy of Engineering identified IT integration as critical to improving health care delivery systems. This paper reviews the state of IT use in the U.S. health care system, its role in facilitating evidence-based practices, and identifies key attributes of an ideal IT infrastructure and issues surrounding IT implementation. We also examine structural, financial, policy-related, cultural, and organizational barriers to IT implementation for evidence-based practice and strategies to overcome them. T he U.S. health care system is a $1.6-trillion industry that is undergoing rapid changes, facing increasing market pressure and competition for scarce resources. 1 The industry involves multiple private and public stakeholders, including provider associations, health care delivery organizations, insurers, consumers, community networks, and local, state, and federal agencies. It is an information intensive industry, 2 and yet it has lagged behind other industries in its investments and use of communication and information technology (IT). [3][4][5] The acquisition and implementation of IT have great implications for the operations of health care organizations because of: (1) rapidly rising health care costs; (2) escalating concerns surrounding issues of patient safety and medical errors; (3) call for improving the provision of evidence-based care; and (4) increasing regulatory requirements. 2,6 In particular, the Institute of Medicine (IOM) and the National Academy of Engineering have identified IT as crucial for building an improved health care delivery system that achieves the 6 health system 21st century attributes of being safe, effective, patientcentered, timely, efficient, and equitable. 3 Industry groups outside of health care, such as the Leapfrog Group, as well as the U.S. government, have encouraged IT investments as a solution to reduce medication errors and patient safety problems. 7-9 IT use has been shown to yield significant improvements in quality, cost containment, and patient safety in several empirical studies. [10][11][12] However, relatively little research has focused on identifying effective approaches for IT implementation and applications in evidence-based practices (EBPs). Evidence-based practice is the process of using current best evidence from well-designed research conscientiously and judiciously, in conjunction with patient values and clinical expertise, to guide health care dec...

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Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs

Cited by 1,351 publications

References 11 publications

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

Challenges Facing Primary Care Practices Aiming to Implement Patient-Centered Medical Homes

ODDIN: Ontology-driven differential diagnosis based on logical inference and probabilistic refinements

Priorities and strategies for the implementation of integrated informatics and communications technology to improve evidence-based practice

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