Since the more technologically advanced hospitals had lower, in-hospital mortality rates, according to study co-author and assistant professor Michael Furukawa, their research findings support previous studies that show “you need the advanced implementation to achieve patient quality benefits,” Furukawa said
In a section on the limitations of their report, the ASU study authors emphasized that they focused on the short-term effects of electronic record systems.
“We looked at the first three years of implementation,” Furukawa said. “So this is kind of the short-term impact. These hospitals could be in the process of training and customization.”
The bottom line, Furukawa said, “In the short term, there may be these negative impacts and so don't expect savings in the short-term.”
Raghu said a couple of factors may be at work to drive up nurse staffing hours. One may be the failure by some hospitals to make the requisite changes in processes needed to leverage the technology.
Raghu said many hospital administrators acknowledged their systems weren't producing a hoped-for level of return on investment, but the hospital leaders said they still felt compelled—for other reasons—to go forward with their technology programs.
“They said: 'If we don't do it, we may not be able to recruit staff,'” Raghu said. “My own opinion is that IT is inevitable, but it might take longer than expected to see a return on the investment.”
“As long as you don't go looking for ways to change the process, you won't get the change you want,” Raghu said.
“The other thing that might be going on is where these systems are,” Raghu said, meaning the physical location of the computer terminals that nurses use. In some hospitals, he said, “The nurses have to run around and go back to document patent care. It's terribly inconvenient, so the patient documentation time might actually increase. They have to be convenient as well as easy to use.
“It's not about the technology,” Raghu said. “Technology plays a crucial rule, but if you don't understand the rewards and incentives and the whole business culture, you will not be successful.”
Co-author and associate professor Benjamin Shao said executives in many other industries experienced little or no gain from their initial IT investments, so healthcare leaders should take courage.
“People should not lose hope,” Shao said. “This is a transitional period. Maybe the hospital administrators and management need to share their own experience in adoption of health IT. There may be some factors that need to be present, like culture and leadership to be able to realize the potential benefits of health IT.”