Relationship Between Use of Electronic Health Record Features and Health Care Quality

Poon, Eric G.; Wright, Adam; Simon, Steven R.; Jenter, Chelsea A.; Kaushal, Rainu; Volk, Lynn A.; Cleary, Paul D.; Singer, Janice; Tumolo, Alexis Z.; Bates, David W.

doi:10.1097/mlr.0b013e3181c16203

Cited by 116 publications

(89 citation statements)

References 19 publications

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“…Several previous studies found no effect. [6][7][8][9][10] Others found modest effects for some, but not all, of the quality measures considered. [11][12][13] Still others were positive, but took place mostly in academic medical centers or integrated delivery systems with home-grown, rather than commercially available, EHRs.…”

Section: Introductionmentioning

confidence: 99%

“…5,14 Few studies have taken place in communities with multiple payers and commercially available EHRs, which are typical of most American communities. 15 Previous studies have also been limited by nonuniversal use of concurrent control groups, 12 lack of adjustment for patient case mix, [6][7][8][9][10][11][12][13] and small or unknown sample sizes of patients per quality measure per physician. [6][7][8][9][10][11][12][13] We sought to determine the effect of commercially available EHRs on ambulatory quality in a multi-payer community, while addressing many of the other limitations of the previous literature.…”

Section: Introductionmentioning

confidence: 99%

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Electronic Health Records and Ambulatory Quality of Care

et al. 2012

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CONTEXT: The US Federal Government is investing up to $29 billion in incentives for meaningful use of electronic health records (EHRs). However, the effect of EHRs on ambulatory quality is unclear, with several large studies finding no effect. OBJECTIVE: To determine the effect of EHRs on ambulatory quality in a community-based setting. DESIGN: Cross-sectional study, using data from 2008. SETTING: Ambulatory practices in the Hudson Valley of New York, with a median practice size of four physicians. PARTICIPANTS:We included all general internists, pediatricians and family medicine physicians who: were members of the Taconic Independent Practice Association, had patients in a data set of claims aggregated across five health plans, and had at least 30 patients per measure for at least one of nine quality measures selected by the health plans. IINTERVENTION: Adoption of an EHR. MAIN OUTCOME MEASURES: We compared physicians using EHRs to physicians using paper on performance for each of the nine quality measures, using t-tests. We also created a composite quality score by standardizing performance against a national benchmark and averaging standardized performance across measures. We used generalized estimation equations, adjusting for nine physician characteristics. KEY RESULTS: We included 466 physicians and 74,618 unique patients. Of the physicians, 204 (44 %) had adopted EHRs and 262 (56 %) were using paper. Electronic health record use was associated with significantly higher quality of care for four of the measures: hemoglobin A1c testing in diabetes, breast cancer screening, chlamydia screening, and colorectal cancer screening. Effect sizes ranged from 3 to 13 percentage points per measure. When all nine measures were combined into a composite, EHR use was associated with higher quality of care (sd 0.4, p= 0.008). CONCLUSIONS: This is one of the first studies to find a positive association between EHRs and ambulatory quality in a community-based setting.KEY WORDS: electronic health records; primary health care; quality of health care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Electronic Health Records and Ambulatory Quality of Care

et al. 2012

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“…Much recent research and practice focuses on developing integrated EMRs (Poon et al, 2010;Resnick et al, 2004;Wang et al, 2009). Based on principles of inter-operability, such systems allow the sharing of health-related information across geographically distributed healthcare workers and administrators.…”

Section: Discussionmentioning

confidence: 99%

Knowledge sharing and health-care coordination: the role of creation and use brokers

et al. 2014

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“…3 As part of Stage 1 and 2 "meaningful use" guidelines, providers are required to actively "maintain an upto-date problem list of current and active diagnoses," with 80% of patients having at least one problem recorded or an indication of no known problems. 4,5 However, research has shown that problem lists are frequently inaccurate and out-of-date. [6][7][8][9][10] In a previous study, we demonstrated that common problems were frequently omitted from the problem list at one large hospital network-completeness ranged from 4.7% for renal disease to a maximum of 78.5% for breast cancer.…”

Section: Introductionmentioning

confidence: 99%