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Communications of the ACM

Economic and business dimensions

Electronic Health Records and Patient Safety

Electronic Health Records and Patient Safety, illustrative photo


U.S. healthcare has made huge investments in health information technologies (IT). The U.S. Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 earmarked more than $20 billion to foster electronic health records (EHRs) at U.S. hospitals and other medical facilities, and facilities have spent billions of their own to digitize patient records and clinical workflows. What benefits have accrued? Have EHRs lowered the cost and improved the quality of healthcare? In particular, what has been the effect of EHRs on patient safety?

There is some evidence that EHRs reduce costs over the long term and under the right conditions.2,a But evidence is scant on the effect of EHRs on patient safety. An Institute of Medicine (IOM) 2012 study, Health IT and Patient Safety, concluded, "current literature is inconclusive about the overall impact of health IT on patient safety." This lack of evidence prompted an econometric study of patient safety at Pennsylvania (PA) hospitals. Patient safety improved for Pennsylvania hospitals that adopted EHRs: a 27% decline in overall patient safety events and a 30% decline in medication errors.b


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