CINS, HC UFMG e PAHO publicam revisão sobre Registro Eletrônico em Saúde
Pesquisadores do CINS, do Hospital das Clinicas da UFMG e colaboradores da PAHO publicam revisão sobre Registro Eletrônico em Saúde na JMIR Medical Informatics – agosto de 2017 (em inglês). Acesse a versão online ou abra o arquivo em PDF.
Is There Evidence of Cost Benefits of Electronic Medical Records,
Standards, or Interoperability in Hospital Information Systems?
Overview of Systematic Reviews
Zilma Silveira Nogueira Reis(1)*, MD, PhD; Thais Abreu Maia(2)*, MBA, MSc; Milena Soriano Marcolino(3)*, MD, PhD; Francisco Becerra-Posada(4)*, MD, DrPH; David Novillo-Ortiz(4)*, MLIS, PhD; Antonio Luiz Pinho Ribeiro(5)*, MD, PhD
1 Informatics Center in Health, Obstetrics and Gynecology Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
2 State Health Secretariat of Minas Gerais, Planning Advisory, Belo Horizonte, Minas Gerais, Brazil
3 Faculty of Medicine, Internal Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
4 Pan American Health Organization, Washington, DC, DC, United States
5 Medical School, Telehealth Center, Hospital das Clínicas, Internal Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
*all authors contributed equally
Zilma Silveira Nogueira Reis, MD, PhD
Informatics Center in Health
Obstetrics and Gynecology Department
Universidade Federal de Minas Gerais
Av. Prof. Alfredo Balena, 190
Belo Horizonte, Minas Gerais, 30130100
Phone: 55 3134099648
Background: Electronic health (eHealth) interventions may improve the quality of care by providing timely, accessible
information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized
health information systems. However, interoperability among systems depends on the adoption of information standards.
Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for
Objective: The objective of this study was to assess cost-effectiveness of the use of electronically available inpatient data
systems, health information exchange, or standards to support interoperability among systems.
Methods: An overview of systematic reviews was conducted, assessing the MEDLINE, Cochrane Library, LILACS, and IEEE
Library databases to identify relevant studies published through February 2016. The search was supplemented by citations from
the selected papers. The primary outcome sought the cost-effectiveness, and the secondary outcome was the impact on quality
of care. Independent reviewers selected studies, and disagreement was resolved by consensus. The quality of the included studies
was evaluated using a measurement tool to assess systematic reviews (AMSTAR).
Results: The primary search identified 286 papers, and two papers were manually included. A total of 211 were systematic
reviews. From the 20 studies that were selected after screening the title and abstract, 14 were deemed ineligible, and six met the
inclusion criteria. The interventions did not show a measurable effect on cost-effectiveness. Despite the limited number of studies,
the heterogeneity of electronic systems reported, and the types of intervention in hospital routines, it was possible to identify
some preliminary benefits in quality of care. Hospital information systems, along with information sharing, had the potential to
improve clinical practice by reducing staff errors or incidents, improving automated harm detection, monitoring infections more
effectively, and enhancing the continuity of care during physician handoffs.
Conclusions: This review identified some benefits in the quality of care but did not provide evidence that the implementation
of eHealth interventions had a measurable impact on cost-effectiveness in hospital settings. However, further evidence is needed
to infer the impact of standards adoption or interoperability in cost benefits of health care; this in turn requires further research.