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Electronic Health Record Components and the Quality of Care

Bibliographic Data

ID9098489
AuthorsSalomeh Keyhani (0000-0001-9124-9618, James J. Peters VA Medical Center, corresponding author), Paul L Hebert (0000-0002-5886-7964), James Stirling Ro (0000-0002-9218-3320, James J. Peters VA Medical Center, corresponding author), Joseph S Ross, Alex D Federman (0000-0002-4824-064X), Alex Federman, Carolyn W Zhu (0000-0002-2318-715X, James J. Peters VA Medical Center, corresponding author), Albert L Siu (0000-0001-6330-8502, James J. Peters VA Medical Center, corresponding author)
Year2008
Volume46
Issue12
Pages1267-1272
Publication date2008-12-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31817e18ae
PMID19300317
OpenAlexW2080553867
LanguageEN
Citations received6
References cited25

BACKGROUND: Electronic health records (EHRs) have been promoted as an important tool to improve quality of care. We examined the association between EHR components, a complete EHR, and the quality of care. METHODS: Using data from the 2005 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, we conducted a cross-sectional analysis of all visits with an established primary care provider and examined the association between presence of EHR components and: (1) blood pressure control; and (2) receipt of appropriate therapy for chronic conditions. We examined similar associations for complete EHRs which we defined as one that includes physician and nursing notes, electronic reminder system, computerized prescription order entry, test results, and computerized test order entry. We constructed multivariate models to examine the association between EHR components and each outcome controlling for patient sociodemographic, health, physician practice, and geographic factors. RESULTS: We found no association between electronic physician notes and blood pressure control or receipt of appropriate therapies, with the exception of inhaled steroids among asthmatics (adjusted odds ratio 2.86; 95% confidence interval, 1.12-7.32). We found no association between electronic reminder systems and blood pressure control or receipt of appropriate therapies, with the exception of angiotensin converting enzyme inhibitors or angiotensin receptor blockers in patients with diabetes with hypertension (odds ratio 2.58; 95% confidence interval, 1.22-5.42). We found no association between electronic physician notes and any measure of quality. We found no relationship between having a complete EHR and any of the quality measures investigated. CONCLUSIONS: We found no consistent association between blood pressure control, management of chronic conditions, and specific EHR components. Future research focusing on how an EHR is implemented and used and how care is integrated through an EHR will improve our understanding of the impact of EHRs on the quality of care

Ambulatory care · Confidence interval · Cross-sectional study · Family medicine · Health care · Logistic regression · Medical prescription · Medical record · Odds · Odds ratio · Receipt · Electronic Health Records Systems · Emergency Medicine · Internal Medicine · Medicine · Nursing · Nursing Diagnosis and Documentation · Primary Care and Health Outcomes

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Citations per year0.43
Citation span2012 - 2024 (13)
Highly citedNo

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