Electronic Health Records and Ambulatory Quality of Care

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The Issue

The U.S. government is providing $29 billion in incentives to encourage "meaningful use" of electronic health records (EHRs)—to create patient registries, track patient outcomes for quality improvement purposes, and facilitate evidence-based decisions about treatment. Despite the push for practices to adopt the technology, few studies have looked at the impact of commercially available EHRs on the quality of ambulatory care, especially in communities with multiple payers.  


What the Study Found

A Commonwealth Fund–supported researcher team compared the quality of care provided by 204 primary care physicians in New York’s Hudson Valley region who used EHRs with 262 providers who relied instead on paper records. The physicians using EHRs performed better on four of 10 quality-of-care measures. They were more likely to perform hemoglobin A1c testing for patients with diabetes, breast cancer screening, chlamydia screening, and colorectal cancer screening. The magnitude of the differences between EHR use and paper for these measures ranged from approximately three to 13 percentage points.


Conclusions

Primary care practices that use EHRs in ambulatory care settings provide significantly higher rates of recommended care, even when multiple payers are involved. Prior to this study, EHR use was shown to improve quality of care only in highly integrated health systems like Kaiser Permanente. Since most health care in the U.S. is delivered in "open" systems, this study’s findings support continuing the national effort to promote meaningful use of EHRs in primary care.

Publication Details

Publication Date:
November 30, 2012
Authors:
Lisa M. Kern, M.D., M.P.H., Yolanda Barrón, M.S., Rina V. Dhopeshwarkar, M.P.H., Alison Edwards, M.Stat., and Rainu Kaushal, M.D., M.P.H.
Summary Writer:
Naomi Freundlich
Citation:
L. M. Kern, Y. Barrón, R. V. Dhopeshwarkar et al., "Electronic Health Records and Ambulatory Quality of Care," Journal of General Internal Medicine, published online Oct. 2012.
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