A series of reports in the April issue of Health Affairs examine the trek toward meaningful use of electronic health records systems a year after enactment of the HITECH Act. Among them:

* A study by the Center for IT Leadership at Partners HealthCare System analyzed the value of four enterprise I.T. systems across the Veterans Administration, finding $3.09 billion in "potential" cumulative net benefits while improving care quality.

* Members of the Premier Inc. provider alliance created a meaningful use best practices library. The library includes specific instructions on ways to speed implementation of computerized physician order entry, medication management, clinical documentation, reporting of measures, privacy policies, information exchange, and management of population health and personal health records. Bill Spooner, CIO at Sharp HealthCare, and Craig Richardville, CIO at Carolinas HealthCare System, led the effort.

* Two studies find that adoption of health I.T. is not a magic bullet for improving quality, but is highly dependent on how the technology is implemented and the environment in which it's implemented.

* A study of the use of EHRs and CPOE found higher quality improvements in academic hospitals than in non-academic facilities.

* Authors of another study call for an expanded definition of meaningful use to measure patient experiences with EHRs. The authors found that nearly one-third of Group Health Cooperative's patient encounters with primary care physicians were conducted through secure e-mail messaging. Ten percent of patients received test results electronically, 10 percent ordered medication refills online, and 58 percent accessed their Group Health EHRs in 2009.

* Renaissance Health in Cambridge, Mass., and AtlantiCare Special Care Center in Atlantic City, N.J., share lessons learned from adopting an EHR in their medical home practices for chronically ill patients. Limitations in the technology led to medication errors, workflow interruptions and other problems common to paper-based systems. The authors recommend consideration of alternative software and informatics models before investing in currently available systems.

More information is available at healthaffairs.org.

--Joseph Goedert


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