Electronic medical record (EMR) use may increase the cost of hospital care without improving patient care, a new study in the USA suggests.

The study shows "some real negatives that come with the positives" of EMR use, according to Michael Furukawa, one of the study's authors.

Furukawa and his Arizona State University colleagues Raghu Santanam and Benjamin Shao analysed data from over 300 California hospitals between 1998 and 2007. They found that EMR implementation was linked to higher hospital costs, and in some cases to lower quality of care.

Reducing costs and improving care through IT are difficult priorities to reconcile, according to the authors. "One possibility is that there is a potential trade-off, you either use IT to improve quality or you reduce the cost, but you may not be able to deliver on both fronts," Shao commented.

The report also found that:

• hospitals saw better results from the use of EMR as its implementation became more advanced, leading to potential cost savings over time

• overtime payments to nurses were reduced through the adoption of real-time data entry

• better-educated nurses were needed to implement EMR systems effectively, posing a challenge in terms of staff management

• EMR use reduced the hospital death rates for certain conditions, as well as reducing medication errors and the use of unnecessary duplicate tests.

According to Shao, these mixed findings suggest that healthcare IT is going through "an early transitional period, where adopters are going through some pains to realise the benefits that we expect to see. Our message is don't lose hope, the chances are that we're in the early stage of adoption and eventually, in the long run, we'll see the benefits."