Typical electronic health record use in primary care practices and the quality of diabetes care

Jesse C. Crosson, Pamela A. Ohman-Strickland, Deborah Cohen, Elizabeth C. Clark, Benjamin F. Crabtree

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

PURPOSE Recent efforts to encourage meaningful use of electronic health records (EHRs) assume that widespread adoption will improve the quality of ambulatory care, especially for complex clinical conditions such as diabetes. Cross-sectional studies of typical uses of commercially available ambulatory EHRs provide confl icting evidence for an association between EHR use and improved care, and effects of longer-term EHR use in community-based primary care settings on the quality of care are not well understood. METHODS We analyzed data from 16 EHR-using and 26 non-EHR-using practicesin 2 northeastern states participating in a group-randomized quality improvement trial. Measures of care were assessed for 798 patients with diabetes. We used hierarchical linear models to examine the relationship between EHR use and adherence to evidence-based diabetes care guidelines, and hierarchical logistic models to compare rates of improvement over 3 years. RESULTS EHR use was not associated with better adherence to care guidelines or a more rapid improvement in adherence. In fact, patients in practices that did not use an EHR were more likely than those in practices that used an EHR to meet all of 3 intermediate outcomes targets for hemoglobin A1c, lowdensity lipoprotein cholesterol, and blood pressure at the 2-year follow-up (odds ratio = 1.67; 95% CI, 1.12-2.51). Although the quality of care improved across all practices, rates of improvement did not differ between the 2 groups. CONCLUSIONS Consistent use of an EHR over 3 years does not ensure successful use for improving the quality of diabetes care. Ongoing efforts to encourage adoption and meaningful use of EHRs in primary care should focus on ensuring that use succeeds in improving care. These efforts will need to include provision of assistance to longer-term EHR users.

Original languageEnglish (US)
Pages (from-to)221-227
Number of pages7
JournalAnnals of Family Medicine
Volume10
Issue number3
DOIs
StatePublished - May 2012

Fingerprint

Electronic Health Records
Quality of Health Care
Primary Health Care
Guidelines
Long-Term Care
Ambulatory Care
Quality Improvement
Linear Models
Hemoglobins
Cross-Sectional Studies
Logistic Models
Odds Ratio

Keywords

  • Computerized
  • Diabetes mellitus
  • Electronic health records
  • Electronic medical records
  • Medical record system
  • Ppractice-based research
  • Primary health care
  • Quality of health care

ASJC Scopus subject areas

  • Family Practice

Cite this

Typical electronic health record use in primary care practices and the quality of diabetes care. / Crosson, Jesse C.; Ohman-Strickland, Pamela A.; Cohen, Deborah; Clark, Elizabeth C.; Crabtree, Benjamin F.

In: Annals of Family Medicine, Vol. 10, No. 3, 05.2012, p. 221-227.

Research output: Contribution to journalArticle

Crosson, Jesse C. ; Ohman-Strickland, Pamela A. ; Cohen, Deborah ; Clark, Elizabeth C. ; Crabtree, Benjamin F. / Typical electronic health record use in primary care practices and the quality of diabetes care. In: Annals of Family Medicine. 2012 ; Vol. 10, No. 3. pp. 221-227.
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