Basit Chaudhry, MD; Jerome Wang, MD; Shinyi Wu, PhD; Margaret Maglione, MPP; Walter Mojica, MD; Elizabeth Roth, MA; Sally C. Morton, PhD; Paul G. Shekelle, MD, PhD
Disclaimer: The authors of this article are responsible for its contents. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality. Statements made in this publication do not represent the official policy or endorsement of the Agency or the U.S. government.
Acknowledgments: The authors thank the Veterans Affairs/University of California, Los Angeles, Robert Wood Johnson Clinical Scholars Program, the University of California, Los Angeles, Division of General Internal Medicine and Health Services Research, and RAND for their support during this research. They also thank Drs. Robert Brook, Kenneth Wells, and Kavita Patel for their review of the manuscript.
Grant Support: This work was produced under Agency for Healthcare Research and Quality contract no. 2002. In addition to the Agency for Healthcare Research and Quality, this work was also funded by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, and the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Basit Chaudhry, MD, Division of General Internal Medicine, University of California, Los Angeles, 911 Broxton Avenue, 2nd Floor, Los Angeles, CA 90095; e-mail, BChaudhry@mednet.ucla.edu.
Current Author Addresses: Dr. Chaudhry: Division of General Internal Medicine, University of California, Los Angeles, 911 Broxton Avenue, 2nd Floor, Los Angeles, CA 90095.
Dr. Wang: Cedars-Sinai Health System, 8700 Beverly Boulevard, Los Angeles, CA 90048.
Drs. Wu, Mojica, and Shekelle, Ms. Maglione, and Ms. Roth: RAND Corporation, 1776 Main Street, Santa Monica, CA 90401.
Dr. Morton: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709.
Experts consider health information technology key to improving efficiency and quality of health care.
To systematically review evidence on the effect of health information technology on quality, efficiency, and costs of health care.
The authors systematically searched the English-language literature indexed in MEDLINE (1995 to January 2004), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Abstracts of Reviews of Effects, and the Periodical Abstracts Database. We also added studies identified by experts up to April 2005.
Descriptive and comparative studies and systematic reviews of health information technology.
Two reviewers independently extracted information on system capabilities, design, effects on quality, system acquisition, implementation context, and costs.
257 studies met the inclusion criteria. Most studies addressed decision support systems or electronic health records. Approximately 25% of the studies were from 4 academic institutions that implemented internally developed systems; only 9 studies evaluated multifunctional, commercially developed systems. Three major benefits on quality were demonstrated: increased adherence to guideline-based care, enhanced surveillance and monitoring, and decreased medication errors. The primary domain of improvement was preventive health. The major efficiency benefit shown was decreased utilization of care. Data on another efficiency measure, time utilization, were mixed. Empirical cost data were limited.
Available quantitative research was limited and was done by a small number of institutions. Systems were heterogeneous and sometimes incompletely described. Available financial and contextual data were limited.
Four benchmark institutions have demonstrated the efficacy of health information technologies in improving quality and efficiency. Whether and how other institutions can achieve similar benefits, and at what costs, are unclear.
Table. Health Information Technology Frameworks
Search flow for health information technology (HIT) literature.Pediatrics
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.
Basit Chaudhry, Jerome Wang, Shinyi Wu, Margaret Maglione, Walter Mojica, Elizabeth Roth, et al. Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Ann Intern Med. 2006;144:742–752. doi: 10.7326/0003-4819-144-10-200605160-00125
Download citation file:
Published: Ann Intern Med. 2006;144(10):742-752.
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