The Impact of eHealth on the Quality and Safety of Health Care

Many health systems are investing heavily in IT-based systems that aim to improve the quality and safety of health care. For example, England has invested at least £12.8 billion in a National Programme for Information Technology (NPfIT) for the National Health Service, and the Obama administration in the United States (US) has similarly committed to a US$38 billion eHealth investment in health care. Examples of such investment include electronic health records (EHRs), picture archiving and communication systems (PACS), electronic prescribing (ePrescribing) and associated computerised provider (or physician) order entry systems (CPOE), and computerised decision support systems (CDSSs).

Policy makers hope that this investment will help address the problems of variable quality and safety in health care delivery. However, the scientific basis of such claims—remains to be established. A recent systematic review by Ashly Black and colleagues published in the journal PLoS Medicine aimed to investigate this question.The study found that there is a large gap between the proposed and demonstrated benefits of eHealth technologies. Moreover, there was a lack of methodologically sound research on the risks of implementing these technologies and their cost-effectiveness was yet to be demonstrated. Because of this, future eHealth technologies should be evaluated against a comprehensive set of measures, ideally throughout all stages of the technology's life cycle.

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