Reporting on contextual and implementation details of clinical decision support tools and computerized provider order entry systems has been “poor,” according to study funded by the Office of the National Coordinator for Health IT and published in the Annals of Internal Medicine, FierceEMR reports.
Inadequate reporting on CDS and CPOE can make it difficult to determine why some electronic health record systems are implemented successfully while others fail, according to the study.
Background
Both CDS and CPOE are requirements of the meaningful use program.
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHR systems can qualify for Medicaid and Medicare incentive payments.
Study Details
For the study, RAND researchers examined 236 studies on EHR systems and outcomes, concentrating on meaningful use requirements.
The researchers found that 56% of the studies focused on CDS and CPOE, and a majority reported a positive or mixed positive result.
However, researchers found that 12 of the 25 meaningful use requirements were not evaluated in the studies, despite their importance to functionality.
Recommendations
The researchers recommended changing the way EHRs and meaningful use are evaluated.
They wrote, “Stakeholders with interests in health IT … can help researchers shift their focus from if to how by promoting, soliciting and publishing research that empirically studies the mediating effects of contextual and implementation factors on the relationship between health IT and key health care outcomes.”
They added, “Such a shift in focus will greatly advance the science of health IT evaluation and greatly increase our understanding of how the positive effects of health IT can be maximized and negative effects can be avoided or remediated” (Durben Hirsch, FierceEMR, 1/13).Source
