The effect of electronic medical records (EMRs) on quality of care in physicians’ offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care.
BuntinMBJainSHBlumenthalD. Health information technology: laying the infrastructure for national health reform. Health Aff (Millwood). 2010;29:1214-1219.
2.
ChaudhryBWangJWuS. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 2006;144:742-752.
3.
GoldzweigCLTowfighAMaglioneMShekellePG. Costs and benefits of health information technology: new trends from the literature. Health Aff (Millwood). 2009;28:w282-w293.
4.
BuntinMBBurkeMFHoaglinMCBlumenthalD. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff (Millwood). 2011;30:464-471.
5.
KeyhaniSHebertPLRossJSFedermanAZhuCWSiuAL. Electronic health record components and the quality of care. Med Care. 2008;46:1267-1272.
6.
LinderJAMaJBatesDWMiddletonBStaffordRS. Electronic health record use and the quality of ambulatory care in the United States. Arch Intern Med. 2007;167:1400-1405.
7.
RomanoMJStaffordRS. Electronic health records and clinical decision support systems: impact on national ambulatory care quality. Arch Intern Med. 2011;171:897-903.
8.
SamalLLinderJALipsitzSRHicksLS. Electronic health records, clinical decision support, and blood pressure control. Am J Manag Care. 2011;17:626-632.
9.
PoonEGWrightASimonSR. Relationship between use of electronic health record features and health care quality: results of a statewide survey. Med Care. 2010;48:203-209.
10.
CrossonJCBazemoreAWPhillipsRLJr. EHR implementation without meaningful use can lead to worse outcomes. Am Fam Physician. 2011;84:1220.
11.
CrossonJCOhman-StricklandPACohenDJClarkECCrabtreeBF. Typical electronic health record use in primary care practices and the quality of diabetes care. Ann Fam Med. 2012;10:221-227.
12.
CrossonJCOhman-StricklandPAHahnKA. Electronic medical records and diabetes quality of care: results from a sample of family medicine practices. Ann Fam Med. 2007;5:209-215.
13.
HsiaoCJCherryDKBeattyPCRechtsteinerEA. National Ambulatory Medical Care Survey: 2007 summary. Natl Health Stat Report. 2010;(27):1-32.
14.
SmithSCJrAllenJBlairSN, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update endorsed by the National Heart, Lung, and Blood Institute. J Am Coll Cardiol. 2006;47:2130-2139.
15.
US Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed.Baltimore, MD: Williams & Wilkins; 1996.
16.
National Heart, Lung, and Blood Institute. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Bethesda, MD: National Institutes of Health; 2005.
17.
ChobanianAVBakrisGLBlackHR. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institute of Health, National Health, Lung, and Blood Institute; 2003.
18.
BeersMH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Arch Intern Med. 1997;157:1531-1536.
19.
ZhanCSanglJBiermanAS. Potentially inappropriate medication use in the community-dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey. JAMA. 2001;286:2823-2829.
20.
SnowVMottur-PilsonCGonzalesR. Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults. Ann Intern Med. 2001;134:487-489.
21.
FickDMCooperJWWadeWEWallerJLMacleanJRBeersMH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003;163:2716-2724.
MaJStaffordRS. Quality of US outpatient care: temporal changes and racial/ethnic disparities. Arch Intern Med. 2005;165:1354-1361.
24.
DonabedianA. Methods for deriving criteria for assessing the quality of medical care. Med Care Rev. 1980;37:653-698.
25.
BurtCWSiskJE. Which physicians and practices are using electronic medical records?Health Aff (Millwood). 2005;24:1334-1343.
26.
GaalSvan den HomberghPVerstappenWWensingM. Patient safety features are more present in larger primary care practices. Health Policy. 2010;97:87-91.
27.
RussellGDahrougeSTunaMHoggWGeneauRGebremichaelG. Getting it all done. Organizational factors linked with comprehensive primary care. Fam Pract. 2010;27:535-541.
28.
AshworthMSchofieldPSeedPDurbabaSKordowiczMJonesR. Identifying poorly performing general practices in England: a longitudinal study using data from the quality and outcomes framework. J Health Serv Res Policy. 2011;16:21-27.
29.
DeyoRACherkinDCCiolMA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613-619.
