tag:blogger.com,1999:blog-9181810725696409953.post6739414899412280205..comments2024-03-17T04:20:11.083-04:00Comments on The Population Health Blog: Here's a Whopper of a Prediction from National Coordinator Blumenthal About the EHR That Hasn't Quite Worked OutJaan Sidorovhttp://www.blogger.com/profile/05072456803925863874noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-9181810725696409953.post-61783221000440490312011-01-03T22:06:16.527-05:002011-01-03T22:06:16.527-05:00Hi Roger!
I interpreted Table 4 by looking at the...Hi Roger!<br /><br />I interpreted Table 4 by looking at the confidence intervals, which crossed 1 (the comparator), meaning they failed to achieve statistical significance. The little superscript "C" denoting p <.05 could only be applied to one measure.<br /><br />Your point about the baseline, the measures that were chosen and other dimensions "on the ground" is a good point. <br /><br />That being said, with our national mania for "evidence-based medicine" and "comparative effectiveness," you'd think that our headlong rush into electronic records was built more on science and less on faith.<br /><br />JaanJaan Sidorovhttps://www.blogger.com/profile/05072456803925863874noreply@blogger.comtag:blogger.com,1999:blog-9181810725696409953.post-34350535334577708592011-01-03T21:01:55.069-05:002011-01-03T21:01:55.069-05:00…and Dr Sidarov should read the RAND article more ...…and Dr Sidarov should read the RAND article more carefully.<br /><br />While there’s certainly been overselling of the benefits of EHR, the article clearly shows that “more” EHR was associated with higher measures of quality at the end of the study period for every diagnosis cited. (Take a look at Table 4). <br /><br />The article does also show that the measures of quality did not increase as much in EHR hospitals over the study period as in ones without EHR — but just possibly because they were doing a better job to begin with.<br /><br />Aside from this confusion between absolute quality measures and increases in the measures, the whole study seems flawed by RAND’s selection of such simplistic measures. Non-performance of some of the care processes listed may certainly be indicative of quality problems, but surely most patients were receiving more extensive treatment — something that might well be influenced by EHR capabilities. The study neither addresses this, nor does the article mention the possibility.Roger Collierhttp://www.reformupdate.blogspot.comnoreply@blogger.com