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'Wired' Hospitals Post Lower Death, Complication Rates
Date:1/27/2009

hwestern Medical Center at Dallas. "Computers and, in particular, electronic decision support, provides enormous adjunct service [to physicians and other health-care professionals] when taking care of patients."

Some of the components can act as a sort of spell check for doctors, for example, alerting physicians to changes in a patient's vitals, or noting a medication discrepancy. It can also improve communication among the various layers of staff now caring for any one patient.

The authors compared inpatient death rates, complications, length-of-stay and cost associated with greater and lesser levels of automation in 41 Texas hospitals.

The analysis involved more than 167,000 individuals over the age of 50 who were hospitalized between Dec. 1, 2005, and May 30, 2006.

The level of automation was measured by physician interactions with the system, using a tool that takes into account how well the physician is trained in the system, the usability of the system, and other factors.

A 10-point increase in the computerization of notes and records meant a 15 percent decrease in the death rate. This translated into a 1.4 percent mortality rate among those with the highest scoring on notes compared with a 1.9 percent rate among those with the lowest scores, or five fewer deaths per 1,000 patients.

Higher scores in the order entry category were associated with a 9 percent decrease in the risk of a heart attack and a 55 percent decrease in coronary artery bypass graft procedures.

Overall, higher scores in decision support equated with a 16 percent decrease in the rate of complications, while higher scores on test results, order entry and decision support were linked with lower costs.

There was no correlation between length of stay and technology score.

Of course, the success of a health-information technology system depends on so much more than the system itself.

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