Paper may be a more efficient medium than computers for delivering essential patient information to doctors, researchers have found.
Researchers at University College London said, "Paper may offer a unique degree of ecological flexibility, and smaller EPR [electronic patient record] systems may sometimes be more efficient and effective than larger ones."
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The findings, which are corroborated by research from Harvard Business School into electronic patient care records, are another blow to the government's desire to improve patient care and save costs through the NHS's £12.7bn centralised National Programme for IT (NPfIT).
UCL researchers led by Trisha Greenhalgh and commissioned by the Department of Health reported in Milbank Quarterly that EPRs would always need people to interpret the information in the record. "Even though secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient," they said.
In an exhaustive literature review, they found "no evidence that large-scale commercial IT systems in health care produce the benefits anticipated by their architects, and a few high-quality studies suggest that they do not".
They said recent evidence suggested that smaller EPR systems developed organically and in-house may be more successful than large ones imposed from outside.
Chancellor of the exchequer Alistair Darling appeared to acknowledge the problems in large computerised healthcare systems, saying in his pre-budget review that the government would cut some £600m from the NPfIT by downsizing it.