Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. Methods We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). Results We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. Conclusions A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames.

[1]  S. Bekkelund,et al.  A randomized trial of telemedicine efficacy and safety for nonacute headaches , 2017, Neurology.

[2]  John R Seeley,et al.  Web-based Intervention to Promote Physical Activity by Sedentary Older Adults: Randomized Controlled Trial , 2013, Journal of medical Internet research.

[3]  W. T. Summerfelt,et al.  Scalable hospital at home with virtual physician visits: pilot study. , 2015, The American journal of managed care.

[4]  O. Arah,et al.  Mortality Benefits of Antibiotic Computerised Decision Support System: Modifying Effects of Age , 2015, Scientific Reports.

[5]  Todd W. Rice,et al.  An Electronic Tool for the Evaluation and Treatment of Sepsis in the ICU: A Randomized Controlled Trial* , 2015, Critical care medicine.

[6]  A. Localio,et al.  Clinical Decision Support and Palivizumab: A Means to Protect from Respiratory Syncytial Virus. , 2015, Applied clinical informatics.

[7]  D. Bates,et al.  Using electronic health record clinical decision support is associated with improved quality of care. , 2014, American Journal of Managed Care.

[8]  E. Penelo,et al.  Internet-delivered cognitive-behavioural therapy v. conventional guided self-help for bulimia nervosa: long-term evaluation of a randomised controlled trial , 2013, British Journal of Psychiatry.

[9]  Paolo Zanaboni,et al.  Adherence and factors affecting satisfaction in long-term telerehabilitation for patients with chronic obstructive pulmonary disease: a mixed methods study , 2016, BMC Medical Informatics and Decision Making.

[10]  Brett M. Harnett,et al.  Integrating Real-Time Clinical Information to Provide Estimates of Net Clinical Benefit of Antithrombotic Therapy for Patients With Atrial Fibrillation , 2014, Circulation. Cardiovascular quality and outcomes.

[11]  Timothy Bickmore,et al.  Reducing Preconception Risks Among African American Women with Conversational Agent Technology , 2015, The Journal of the American Board of Family Medicine.

[12]  Joseph Restuccia,et al.  Hospital implementation of health information technology and quality of care: are they related? , 2012, BMC Medical Informatics and Decision Making.

[13]  Bruce Neal,et al.  Effect of a Computer-Guided, Quality Improvement Program for Cardiovascular Disease Risk Management in Primary Health Care: The Treatment of Cardiovascular Risk Using Electronic Decision Support Cluster-Randomized Trial , 2015, Circulation. Cardiovascular quality and outcomes.

[14]  P. Margolis,et al.  Reliable Individualized Monitoring Improves Cholesterol Control in Kidney Transplant Recipients , 2013, Pediatrics.

[15]  David Moher,et al.  Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews , 2007, BMC medical research methodology.

[16]  Angela Fagerlin,et al.  Comparison of Community Health WorkerLed Diabetes Medication Decision-Making Support for Low-Income Latino and African American Adults With Diabetes Using E-Health Tools Versus Print Materials , 2014, Annals of Internal Medicine.

[17]  C. Goldzweig,et al.  Costs and benefits of health information technology: new trends from the literature. , 2009, Health affairs.

[18]  W. Haefeli,et al.  How to improve drug dosing for patients with renal impairment in primary care - a cluster-randomized controlled trial , 2012, BMC Family Practice.

[19]  R. McCabe,et al.  The Effectiveness of a Patient-Centred Assessment with a Solution-Focused Approach (DIALOG+) for Patients with Psychosis: A Pragmatic Cluster-Randomised Controlled Trial in Community Care , 2015, Psychotherapy and Psychosomatics.

[20]  D. Blumenthal,et al.  The benefits of health information technology: a review of the recent literature shows predominantly positive results. , 2011, Health affairs.

[21]  W. Lester,et al.  Efficacy of a Clinical Decision-Support System in an HIV Practice , 2012, Annals of Internal Medicine.

[22]  J. Naslund,et al.  Feasibility and effectiveness of an automated telehealth intervention to improve illness self-management in people with serious psychiatric and medical disorders. , 2013, Psychiatric rehabilitation journal.

[23]  A. Haines,et al.  The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review , 2013, PLoS medicine.

[24]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[25]  D. K. Williams,et al.  Practice-Based Versus Telemedicine-Based Collaborative Care for Depression in Rural Federally Qualified Health Centers: A Pragmatic Randomized Comparative Effectiveness Trial. , 2017, Focus.

[26]  K. Szucs,et al.  The Effect of Interactive Web-Based Monitoring on Breastfeeding Exclusivity, Intensity, and Duration in Healthy, Term Infants After Hospital Discharge. , 2016, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[27]  Kevin B. Johnson,et al.  Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: A randomized clinical trial , 2014, Int. J. Medical Informatics.

[28]  M. Modic,et al.  Electronic Stroke CarePath: Integrated Approach to Stroke Care. , 2015, Circulation. Cardiovascular quality and outcomes.

[29]  J. Henry,et al.  Adoption of Electronic Health Record Systems among U . S . Non-Federal Acute Care Hospitals : 2008-2015 , 2013 .

[30]  L. Lenert,et al.  The Utah Remote Monitoring Project: improving health care one patient at a time. , 2014, Diabetes technology & therapeutics.

[31]  Lindsay K. Sonstein,et al.  Improving adherence for management of acute exacerbation of chronic obstructive pulmonary disease. , 2014, The American journal of medicine.

[32]  M. Wolf,et al.  The causal pathways linking health literacy to health outcomes. , 2007, American journal of health behavior.

[33]  Holly L. Lorenz,et al.  Impact of Nurse-Led Remote Screening and Prompting for Evidence-Based Practices in the ICU* , 2014, Critical care medicine.

[34]  S. Magid,et al.  Electronic Ordering System Improves Postoperative Pain Management after Total Knee or Hip Arthroplasty , 2015, Applied Clinical Informatics.

[35]  David Gustafson,et al.  The Effects of Combining Web-Based eHealth With Telephone Nurse Case Management for Pediatric Asthma Control: A Randomized Controlled Trial , 2012, Journal of medical Internet research.

[36]  Todd W. Sands,et al.  Development and pilot testing of a mobile health solution for asthma self-management: asthma action plan smartphone application pilot study. , 2013, Canadian respiratory journal.

[37]  A. Steffen,et al.  A telehealth behavioral coaching intervention for neurocognitive disorder family carers , 2015, International journal of geriatric psychiatry.

[38]  J. Glaser,et al.  Health Care Information Systems: A Practical Approach for Health Care Management , 2009 .

[39]  D. Blumenthal.  Launching HITECH. , 2010, The New England journal of medicine.

[40]  A-Mm Williams,et al.  Effects of an Individually Tailored Web-Based Chronic Pain Management Program on Pain Severity, Psychological Health, and Functioning , 2013, Journal of medical Internet research.

[41]  Lisa M. Kuhns,et al.  A Randomized Controlled Trial of Personalized Text Message Reminders to Promote Medication Adherence Among HIV-Positive Adolescents and Young Adults , 2016, AIDS and Behavior.

[42]  ELSKE AMMENWERTH,et al.  Review Paper: The Effect of Electronic Prescribing on Medication Errors and Adverse Drug Events: A Systematic Review , 2008, J. Am. Medical Informatics Assoc..

[43]  F. Quereshy,et al.  Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity. , 2016, Canadian journal of surgery. Journal canadien de chirurgie.

[44]  N. Powe,et al.  Clinical information technologies and inpatient outcomes: a multiple hospital study. , 2009, Archives of internal medicine.

[45]  Ofir Ben-Assuli,et al.  The impact of EHR and HIE on reducing avoidable admissions: controlling main differential diagnoses , 2013, BMC Medical Informatics and Decision Making.

[46]  Miriam Bender,et al.  Feasibility and Acute Care Utilization Outcomes of a Post-Acute Transitional Telemonitoring Program for Underserved Chronic Disease Patients. , 2015, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[47]  D. Moher,et al.  Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2009, Physical therapy.

[48]  John Doucette,et al.  Adopting electronic medical records in primary care: Lessons learned from health information systems implementation experience in seven countries , 2009, Int. J. Medical Informatics.

[49]  L. Lazzeroni,et al.  Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga , 2017, BMC Complementary and Alternative Medicine.

[50]  G. Jemec,et al.  Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study. , 2015, The Journal of investigative dermatology.