About a decade ago, the Institute of Medicine released a report that indicated as many as 100,000 people die in hospitals each year as a result of avoidable medical errors, roughly the equivalent of a 747 airliner crashing every four days, all year long.
When Corey Angst, assistant professor of management in the University of Notre Dame’s Mendoza College of Business, read that statistic, he wondered why such shocking numbers weren’t getting near the attention that would be paid if hundreds of people were dying each week in, say airplane crashes. He decided to apply his area of specialty to researching solutions for the neglected problem. After all, Angst says, “Hospitals are businesses providing a service to a group of people… in this case patients.”
An expert on health information technology, Angst conducts research on the transformational effect of IT, technology usage and IT value. He is a proponent of national digitization of health record information and believes electronic medical records (EMRs) would standardize processes, increase efficiencies and greatly diminish the potential for medical errors.
“EMRs, for example, allow doctors to see immediately what medications patients are already taking before prescribing others that may interact negatively,” Angst says. “But it’s also about efficiencies. We have opportunities to control and monitor the system itself, and collect data and guide the process of care from the moment patients walk in the door of the hospital to the point that they leave, and then follow-up after that.”
The technology is already available for things such as e-prescribing, which eliminates the often arduous task of deciphering a doctor’s handwriting.
“We no longer have errors being made simply trying to interpret the dosage or figure out what the doctor actually meant.” Angst says.
Angst co-authored e-prescribing papers published last year in both the Journal of the American Medical Informatics Association and Health Affairs, as well as a paper about the diffusion of EMRs in Management Science and another on EMR privacy concerns in MIS Quarterly. He co-authored two papers on healthcare IT value, forthcoming from Production and Operations Management and the Journal of Operations Management.
Although technologies are available, statistics show fewer than 25 percent of U.S. hospitals have adopted EMRs.
“I think that’s a shocking number,” Angst says. “When I talk to people who aren’t very familiar with this industry, they’re stunned. They say, ‘My doctor is using a computer. Doesn’t that mean he has electronic medical records?’ And, in fact, it doesn’t.”
There are two tracks to Angst’s research. One looks at adoption and diffusion of EMRs and e-prescribing, which he says are slow to catch on because people are resistant to change. There’s a learning curve involved, and decision makers are somewhat unsure about the overall value of the systems. With regard to diffusion, Angst’s research shows technologies or innovations within hospitals often spread from hospital to hospital.
“There are certain ‘celebrity’ hospitals that are very infectious,” Angst says. “They are more likely to influence other hospitals to adopt EMRs. Also, some hospitals just adapt better to change, making them more susceptible to influence from others.”
Angst also is studying the value of EMRs and e-prescribing. He’s finding positive results, such as reduction in costs and errors and process improvement, but he acknowledges that there also is evidence of negative or no significant results from other studies. Angst says that’s because some hospitals that have adopted the new technologies may not be using them in a meaningful way. He says when hospitals fully integrate these technologies, you see their true value.
“They are taking data from CT scans, MRIs and other medical technologies within a facility and bringing all of that data into a central hub where it can be used for different purposes,” he says. “Some may be financial, some may be process related, and hopefully some are clinically related, so that tests are not being repeated on patients.”
Or, so that potentially deadly errors are being avoided.
Contact: Corey Angst, 574-631-4772, cangst@nd.edu