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