Electronic health records and perinatal quality: a call to midwives.


Over the last 5 years, there has been an unprecedented interest and investment in health information technology in the United States. The Health Information Technology for Economic and Clinical Health Act, part of the American Recovery and Reinvestment Act of 2009, has committed $27 billion in federal funds for health care providers who convert to “meaningful use” of electronic health records (EHRs) by 2014.1 Despite the federal and technology industry enthusiasm regarding the promise of improved safety and the vision of meaningful use (Table 1),2 a paucity of research has been conducted about EHRs, specifically within the field of perinatal care. Indeed, searching the PubMed and Cumulative Index to Nursing and Allied Health databases for the terms “electronic health record” and 1 of the following terms “perinatal safety,” “prenatal safety,” “neonatal safety,” “obstetric safety,” or “midwifery” resulted in no published articles between the years of 1980 and 2011. No randomized controlled trials relating to perinatal care and electronic health recordswere located as of December 2011. This dearth of research is concerning because perinatal health care makes up a substantial portion of federal spending.3 Midwifery as a profession has struggled with responding to premature adoption of other technologies, such as routine continuous electronic fetal monitoring. As a result, midwives may question focus on health information technology. How will EHRs help the United States to change our poor ranking with regard to maternal mortality and neonatal mortality among developed nations? How will they help providers to lower costs, decrease duplicate testing or inappropriate use of intervention, and improve quality? How does the health information technology infrastructure preserve and promote the hallmarks of midwifery? This commentary explores issues relating to the implementation of EHRs and the provision of high-quality, high-valuematernity carewith a specific emphasis on the preservation of the hallmarks of midwifery.

DOI: 10.1111/j.1542-2011.2012.00185.x

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Cite this paper

@article{Jolles2012ElectronicHR, title={Electronic health records and perinatal quality: a call to midwives.}, author={Diana R Jolles and William Wells Brown and Karen B King}, journal={Journal of midwifery & women's health}, year={2012}, volume={57 4}, pages={315-20} }