Going digital in hospitals better than ‘pin the tail on the donkey’, but benefits not fully understood

Friday, December 1, 2017

Research from Brisbane’s Princess Alexandra Hospital and its parent Metro South Hospital and Health Service highlights that eHealth technologies confer benefits in improving quality and safety in health care, without major hazards, says Australian Health Review (AHR) chief editor Professor Gary Day.

AHR is the Australian Healthcare and Hospitals Association’s peer-reviewed academic journal. The December 2017 issue has been published online today.

‘But despite the obvious advantages, it’s not clear which digital health components affect clinical health outcomes or overall costs the most, or if one component can work effectively without the other’, Prof. Day said.

‘And the eye-watering cost of such systems cannot be ignored—for example £12.8 billion in the UK and $34 billion in the US.’

The Brisbane author team reviewed the cumulative evidence of 19 systematic reviews and two reviews of systematic reviews published over the last 5 years.

They found that there were four basic types of eHealth technologies:

• Electronic Medical Records
• Computerised Provider/Physician Order Entry systems
• Electronic Prescribing (ePrescribing)
• Computerised Decision Support Systems

Electronic Medical Records have the potential to increase accuracy and completeness of clinical information, reduce documentation time, and enhance information transfer and organisational efficiency.

Computerised Provider/Physician Order Entry systems seem to improve laboratory turnaround times, and decrease resource use.

ePrescribing significantly reduces medication errors and adverse drug events.

Computerised Decision Support Systems, especially those used at the point of care and integrated into workflows, attract the strongest evidence for substantially increasing clinician adherence to guidelines, the appropriateness of disease and and treatment monitoring, and optimal medication use. But customisation of such systems to suit patient-centred care and management of highly complex patients with multiple conditions remains a challenge.

‘There are questions whether electronic medical records and computerised provider ordering can affect clinical outcomes or overall costs in the absence of ePrescribing and computer decision support systems’, Prof Day said.

‘This is an ever-changing field—eHealth technologies are evolving rapidly, so there is lack of a stable body of accumulated research linking the theorised benefits with real-world results.’

‘We have an array of other interesting articles in AHR this month—there’s one on older people’s perceptions of the Australian 75+ Health Assessment and whether it is person-centred. Another is on doctor’s attitudes to ‘not for resuscitation’ orders.

‘There’s also an article on recruiting medical specialists to regional centres—it’s more than a question of money.

‘Also included in this month’s issue is an article trialling an intervention with GPs in managing chronic diseases in patients with severe mental illness’, Prof Day said.


Articles from the December 2017 AHR can be found here. Some are freely available through open access, while others need a subscription or can be purchased individually.


The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, and community and primary healthcare services.

Media enquiries: Prof. Gary Day, Editor-in-Chief, Australian Health Review, 0422 236 571