Spencer S. Jones, PhD; Robert S. Rudin, PhD; Tanja Perry, BHM; Paul G. Shekelle, MD, PhD
Acknowledgment: The authors thank Aneesa Motala and Roberta Shanman for their research assistance and assistance with the literature searches and retrieval. They also thank the members of the Technical Expert Panel: David W. Bates, MD, MSc; George Hripsak, MD, MS; Philip J. Aponte, MD; Louise Liang, MD; and Paul Tang, MD, MS.
Grant Support: By the Office of the National Coordinator.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1531.
Requests for Single Reprints: Spencer S. Jones, PhD, Southern California Evidence-Based Practice Center, RAND Health, 1776 Main Street, Santa Monica, CA 90401; e-mail: firstname.lastname@example.org.
Current Author Addresses: Drs. Jones and Shekelle and Ms. Perry: Southern California Evidence-Based Practice Center, RAND Health, 1776 Main Street, Santa Monica, CA 90401.
Dr. Rudin: RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA 02116.
Author Contributions: Conception and design: S.S. Jones, R.S. Rudin, P.G. Shekelle.
Analysis and interpretation of the data: S.S. Jones, R.S. Rudin, P.G. Shekelle.
Drafting of the article: S.S. Jones, R.S. Rudin, T. Perry, P.G. Shekelle.
Critical revision of the article for important intellectual content: S.S. Jones, R.S. Rudin, P.G. Shekelle.
Final approval of the article: S.S. Jones, R.S. Rudin, T. Perry, P.G. Shekelle.
Provision of study materials or patients: S.S. Jones, P.G. Shekelle.
Statistical expertise: S.S. Jones.
Obtaining of funding: S.S. Jones, P.G. Shekelle.
Administrative, technical, or logistic support: T. Perry.
Collection and assembly of data: S.S. Jones, P.G. Shekelle.
Incentives offered by the U.S. government have spurred marked increases in use of health information technology (IT).
To update previous reviews and examine recent evidence that relates health IT functionalities prescribed in meaningful use regulations to key aspects of health care.
English-language articles in PubMed from January 2010 to August 2013.
236 studies, including pre–post and time-series designs and clinical trials that related the use of health IT to quality, safety, or efficiency.
Two independent reviewers extracted data on functionality, study outcomes, and context.
Fifty-seven percent of the 236 studies evaluated clinical decision support and computerized provider order entry, whereas other meaningful use functionalities were rarely evaluated. Fifty-six percent of studies reported uniformly positive results, and an additional 21% reported mixed-positive effects. Reporting of context and implementation details was poor, and 61% of studies did not report any contextual details beyond basic information.
Potential for publication bias, and evaluated health IT systems and outcomes were heterogeneous and incompletely described.
Strong evidence supports the use of clinical decision support and computerized provider order entry. However, insufficient reporting of implementation and context of use makes it impossible to determine why some health IT implementations are successful and others are not. The most important improvement that can be made in health IT evaluations is increased reporting of the effects of implementation and context.
Office of the National Coordinator.
Evidence search and selection.
Table 1. Health IT Evaluation Studies Between 1995 and 2013, by Study Outcome Type
Table 2. Health IT Evaluation Studies Between 2007 and 2013, by Study Outcome Result
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Jones SS, Rudin RS, Perry T, Shekelle PG. Health Information Technology: An Updated Systematic Review With a Focus on Meaningful Use. Ann Intern Med. 2014;160:48–54. doi: 10.7326/M13-1531
Download citation file:
Published: Ann Intern Med. 2014;160(1):48-54.
Healthcare Delivery and Policy.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only