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David Wyatt, MD
Lynn McCallum, MD
Ken Harrington, PM
Raymond Zakhari, NP
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Quality of Care

Electronic health records improve quality of care
New studies emerge each day pointing to the ability for Electronic Health Record to improve patient quality of care and the practice of medicine. Practice Fusion has gathered some of the most recent reports here for your review.

EHR cuts long-term operating costs
"A report from the Medical Group Management Association, based on a survey of 1,324 primary care and specialty practice members, finds significant financial benefits to using an electronic health records system. Englewood, Colo.- based MGMA reports that independent practices had a median of $49,916 more revenue after operating costs per full-time physician in 2009 than paper-based practices." (MGMA - 2010)

Study links electronic health records to improved quality in primary care treatment
"Routine use of electronic health records may improve the quality of care provided in community-based primary care practices more than other common strategies intended to raise the quality of medical care, according to a new study by RAND Corporation researchers." (RAND Corporation - 2009)

Electronic Health Records boost quality of care
"EHRs expand the amount of available patient data available to health care providers, such as notes about the progress of treatment and medications prescribed to patients, as well as data about patient populations. EHRs also improve communication among providers in integrated health care delivery (IDS) systems." (GAO - 2010)

EHR–based decision support improves ADHD care
"Children at intervention sites were more likely to have had a visit during the study period in which their ADHD was assessed. The ADHD template was used at 32% of visits at which patients were scheduled specifically for ADHD assessment, and its use was associated with improved documentation of symptoms, treatment effectiveness, and treatment adverse effects." (Journal of the American Academy of Pediatrics - 2010)

EHRs and quality care for heart failure
"Among practices, 52% had EHR systems (30% EHR-only; 22% both EHR and paper) and 48% paper-only systems. After controlling for patient and site characteristics, use of EHR was associated with improved delivery of 3 of 7 quality measures (angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, aldosterone antagonist, and HF education)." (American Heart Journal - 2010)

e-Prescribing and quality of care
"Most of the features relate to the recording and use of patient data, the medication selection process, prescribing decision support, monitoring drug therapy and clinical reports. The expert group rated 78 of the features (68%) as likely to have a high positive impact in at least one domain, 36 features (32%) as medium impact, and none as low or negative impact. Twenty seven features were rated as high positive impact across 3 or 4 domains including patient safety and quality of care." (BMC Medical Informatics and Decision Making - 2010)

Personal Health Records and Improvement of patient care (PDF)
"Evidence suggests that patient use of personal electronic health records may have a positive impact on relationships between healthcare providers and patients and on some health outcomes." (Canadian Agency for Drugs and Technologies in Health - 2010)

EHR improves primary care clinicians' quality of care over 12 months
"The proportion of clinicians agreeing that the EHR improved the overall quality of care (63% to 86% p<0.001), reduced medication-related errors (72% to 81% p=0.03), improved follow-up of test results (62% to 87% p<0.001), and improved communication among clinicians (72% to 93% p<0.001) increased from month 1 to month 12." (Society of General Internal Medicine – 2009)

EHR boosts care coordination for kidney patients
Electronic Health Records can help improve health outcomes for patients at high risk of kidney disease, according to a study published Wednesday in the British Medical Journal. (iHealthBeat – 2009)

EHR reduces malpractice claims
In a study done by Harvard researchers, 6.1% of physicians with electronic records had malpractice settlements, compared to 10.8% without electronic records. (Computer World – 2008)

EHR reduces infection rates and medical errors
For the first time, all the different doctors involved in a patients care could work from the same chart, using electronic medical records, which drew data together in one place, ensuring that the information was not lost or garbled. The new system had dramatic effects. For instance, it prompted doctors to follow guidelines for preventing infection when dressing wounds or inserting IVs, which in turn caused infection rates to fall by 88 percent. The number of medical errors and deaths also dropped. (Washington Monthly – 2009)

EHR increases mammography rates
Automated reminder programs make it more convenient for people to focus on staying healthy by getting the screenings they need. (Kaiser – 2009)

EMR supports management of childhood obesity
EMRs have been found to improve clinician implementation of clinical guidelines. Bordowitz et al found EMR automatic BMI calculations to improve documentation and treatment of adult obese patients. EMRs also have been used to educate providers regarding their own performance, to guide pediatric care and to facilitate quality improvement efforts. (PEDIATRICS – 2009)