Use of certain electronic health record features is associated with improved primary care quality measures
Research Activities, October 2010, No. 362
Although studies have shown the benefit of electronic health records (EHRs), most of these have only examined the adoption of EHRs as a whole and not focused on specific features within these systems. Recently, a study was conducted that specifically looked at the relationship between various features of EHRs and health care quality. It found that the availability and use of certain features by primary care physicians were associated with better performance on key quality measures such as colon cancer screening.
Researchers conducted a statewide survey of primary care physicians in Massachusetts. A total of 1,345 responded to questions related to their use of EHRs, including features dealing with test results and order entry. Participants were asked if each feature was available to them and how often they used it. Physicians' responses were compared with information on quality measures obtained from the Healthcare Effectiveness Data and Information Set (HEDIS). The final sample included 507 physician users of EHRs. Interestingly, the majority of physicians who responded (71.6 percent) did not use an EHR. There was no significant association between using an EHR overall and the primary care physician's performance on any of the HEDIS outcome measures. Further analysis, however, showed a significant association between the use of a number of specific EHR features and HEDIS measures. These associations were the strongest for measures of women's health, colon cancer screening, and cancer prevention. Specifically, the use of electronic medication lists had a positive association with colon cancer screening and cancer prevention. Electronic prescribing was positively associated with not only colon cancer screening and cancer prevention, but also with well-child care performance.
The researchers conclude that just having an EHR is not sufficient to improve care quality. Quality is only significantly affected when specific features are part of the system and used on a regular basis by the clinician. The study was supported in part by the Agency for Healthcare Research and Quality (HS15397).
See "Relationship between use of electronic health record features and health care quality," by Eric G. Poon, M.D., M.P.H., Adam Wright, Ph.D., Steven R. Simon, M.D., M.P.H., and others in the March 2010 Medical Care 48(3), pp. 203-209.