Impact of IT Systems on NHS Efficiency
Author Information
Author(s): Collin Simon, Reeves Barnaby C, Hendy Jane, Fulop Naomi, Hutchings Andrew, Priedane Eugenia
Primary Institution: University of Bristol
Hypothesis
What is the impact of CPOE and PACS on clinical and operational efficiency in NHS hospitals?
Conclusion
CPOE and PACS were associated with both increases and reductions in tests and examinations, indicating mixed effects on healthcare efficiency.
Supporting Evidence
- CPOE reduced the proportion of outpatient appointments where certain tests were ordered.
- PACS was associated with a reduction in repeat plain x-ray films at outpatient appointments.
- CPOE led to an almost fourfold increase in urea and electrolytes tests among day case patients.
- PACS increased the number of computed tomography requests at outpatient appointments.
- Both systems showed mixed effects on various efficiency outcomes.
Takeaway
This study looked at how two computer systems used in hospitals changed the way tests are ordered. Sometimes they helped reduce unnecessary tests, but other times they led to more tests being done.
Methodology
Quasi-experimental controlled before and after study using routinely collected patient level data.
Potential Biases
Potential for residual confounding and misclassification of tests as redundant.
Limitations
Data quality could not be verified, and the study was susceptible to confounding due to differences in case mix between trusts.
Participant Demographics
Four NHS acute hospital trusts in England.
Statistical Information
Confidence Interval
95% confidence intervals reported for various outcomes.
Digital Object Identifier (DOI)
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