Patients benefit from paperless hospitals

When health information technologies replace paper forms and handwritten notes, both hospitals and patients benefit, said researchers in the Archives of Internal Medicine.

Johns Hopkins University researchers rated clinical information technologies at 41 hospitals in Texas and compared those results with discharge information for 167,233 patients.

They ranked paperless systems such as electronic notes; previous treatment records; test results; orders for drugs, procedures and blood tests; and decision-support systems that offer up-to-date information on treatment options and drug interactions. To rate the effectiveness of the clinical information technologies, they administered a questionnaire to physicians that asked if an electronic system was in place in their hospitals, if they knew how to use it and if they used it consistently. The questionnaire produced numbered scores that allowed researchers to place hospitals in three groups: highest one-third, middle one-third and lowest one-third.

The researchers’ results showed that with computerized automation of notes and records, hospitals whose technologies ranked in the highest one-third were associated with a 15 percent decrease in the odds that a patient would die while hospitalized.

Similarly, the highest scores for electronic “order entry” systems were linked to a 9 percent and 55 percent decrease in the odds of death resulting from heart attacks and coronary artery bypass procedures, respectively.

The highest scores in so-called decision-support systems鈥攃omputerized clinical information that guides a physician’s treatment choices鈥攚ere associated with a 21 percent decrease in the odds that a patient would develop complications.

Researchers also found that hospitals with the highest technology scores in the rating system showed significantly lower patient costs.

“Patients appear safer and hospital bottom lines may improve when health care information is gathered and stored on computers rather than on paper,” said senior author Neil R. Powe, MD, MPH, MBA, of the Department of Medicine at Johns Hopkins University School of Medicine, Baltimore, and the director of the Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore.