June 3, 2011
12 Advances In Medical Robotics
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Slideshow: 12 Advances In Medical Robotics
Greater use of electronic medical records (EMRs) to monitor, update, and share medical information on newborns can help physicians save babies' lives, a study published in the Journal of Political Economy revealed.
A recently published report--"Can Health Care Information Technology Save Babies?"--found that a 10% increase in hospital use of basic EMRs would save 16 babies for every 100,000 live births. A complete national transition to EMRs could save as many as 6,400 infants each year in the U.S. In addition to EMRs, investments in dedicated obstetrics information systems that store fetal ultrasound data, and automatically record fetal heart rates and how they respond to maternal contractions during labor, can result in further prevention of infant deaths soon after birth. The report found that "a 10% increase in hospitals that adopt both EMRs and obstetric-specific computing technology reduces neonatal mortality by 40 deaths per 100,000 live births." Catherine Tucker, the report's co-author who is affiliated with the Massachusetts Institute of Technology's Sloan School of Management, said in an interview that "there has been considerable skepticism among some in the medical community that healthcare information technology (IT) can live up to the claims made for it. However, we find a strong significant pattern of healthcare IT saving neonatal lives, and that better healthcare IT in the form of integration with radiology and digitized work-flow can save even more babies lives." The study compared infant death rates at hospitals with and without digitized medical records in more than 2,500 U.S. counties over 12 years. The extensive data set allowed the researchers to control for other factors that may influence infant mortality, such as a county's socioeconomic status. The study's primary focus was the neonatal death rate, defined as the number of deaths within 28 days per 1,000 live births. Researchers also examined infant mortality within the first day and first week of life as well as the rates of stillbirth and maternal death. In its findings, the study revealed that: "EMR adoption is associated with relative declines in mortality within the first week and first day of life. The magnitudes of these effects suggest that the majority of the gains in neonatal survival are due to improved outcomes within the first 7 days after birth. This pattern of the largest gains occurring soon after the time of birth is consistent with medical care at the hospital playing an important role in the observed variation in health outcomes." According to Tucker, one of the most important lessons gynecologists and obstetricians can learn from the report is EMRs were most useful in saving the lives of babies that suffered from complications of the perinatal period. "They did not help prevent deaths from congenital causes, SIDS, or accidents. This emphasizes the helpfulness of EMRs in terms of providing documentation and an easily accessible patient record history," Tucker said. The report's authors noted that past research on EMRs have, for the most part, focused on the technology's effect on the quality of care and on EMR's ability to reduce costs, but very little empirical data exists to support the view that for gynecologists and obstetricians, EMRs might make it easier to identify high risk pregnancies and coordinate care. Tucker and co-author Amalia Miller of the University of Virginia and the RAND Corporation, also found that EMRs would be cost-effective compared to other healthcare interventions. Both researchers estimate that the cost of saving one baby through EMRs is about $531,000. By comparison, a large expansion in Medicaid coverage for children in the 1980s cost about $840,000 per life saved. "This paper offers evidence that suggests cautious optimism about the potential value of healthcare IT and EMRs in improving neonatal health outcomes and current health policy that is directed toward increasing the spread of these technologies," the authors conclude. Miller and Tucker also noted that the study's results validate the federal government's recent investments to encourage the adoption of EMRs and other health IT systems. "These findings provide an empirical basis for government policy intervention to hasten the diffusion of healthcare IT," the researchers concluded. The Healthcare IT Leadership Forum is a day-long venue where senior IT leaders in healthcare come together to discuss how they're using technology to improve clinical care. It happens in New York City on July 12. Find out more.
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