A new study of the impact upon quality of outpatient medical care of electronic health records might cause some of us to be more careful about our expectations of the relationship between technology and quality of service – or at least of software that makes suggestions based on data.

Here is the key para from the abstract, which appears in the Archives of Internal Medicine.  Full text of the article at same link.

“Electronic health records were used in 30% of an estimated 1.1 billion annual US patient visits. Clinical decision support was present in 57% of these EHR visits (17% of all visits). The use of EHRs and CDS was more likely in the West and in multiphysician settings than in solo practices. In only 1 of 20 indicators was quality greater in EHR visits than in non-EHR visits (diet counseling in high-risk adults, adjusted odds ratio, 1.65; 95% confidence interval, 1.21-2.26). Among the EHR visits, only 1 of 20 quality indicators showed significantly better performance in visits with CDS compared with EHR visits without CDS (lack of routine electrocardiographic ordering in low-risk patients, adjusted odds ratio, 2.88; 95% confidence interval, 1.69-4.90). There were no other significant quality differences.”

Here is assorted less technical media reporting.

Bottom line:  not much impact on outpatient care from having electronic health records or having outpatient caregivers prompted for what patients need.

Obviously, one would need to get a much better handle on whether this is about the design of the software, the training of the medical staff, communication with patients, incentives from payment systems, etc.  Given our experiences of kiosks in which the staff are not sufficiently trained and do not adequately assist litigants, I would like to see a study that looked at the impact of training on impact.

Generally, it is clear that we in the legal innovation world should be keeping an eye on how data is impacting our quality and relationships.

But, tell me, do we have a study even remotely like the above (but then we are not planning to invest $40 billion in electronic legal records!)