By Jesse C. Crosson, PhD, Pamela A. Ohman-Strickland, PhD, Karissa A. Hahn, MPH, Barbara DiCicco-Bloom, RN, PhD, Eric Shaw, PhD, A. John Orzano, MD and Benjamin F. Crabtree, PhD
Annals of Family Medicine
May/June 2007
We assessed the relationship between electronic medical record (EMR) usage and diabetes care quality in a sample of family medicine practices.
…patients with diabetes in practices that did not have an EMR were significantly more likely to have received care that met the guidelines for processes of care, treatment, and intermediate outcomes. For intermediate outcomes, the odds of patients in non-EMR using practices meeting all 3 targets was 2.68 times the odds of patients in EMR-using practices.
http://www.annfammed.org/cgi/content/full/5/3/209
Comment:
By Don McCanne, MD
Those politicians touting electronic medical records (EMRs) as a major component of their reform proposals should take note of this study. Diabetic patients in family practices that did not use EMRs received better care than those in family practices that did.
This is not to say that EMRs are necessarily bad. The experience in the VA health system has been that government-developed EMRs (Vista) assist physicians in improving compliance with accepted standards of care.
The crucial difference is that private practices use competing commercial vendors who are concerned more about gaining market share with systems designed to maximize profits, both for the vendors and for the physicians. The EMR vendors emphasize features such as enhanced billing functions.
In contrast, government-developed systems are designed to enhance quality. In fact, a very modest investment of public funds could be used to adapt the VA’s Vista EMR system into a low-cost, high quality system for the private health care delivery sector (but only after patient privacy issues have been resolved).
In the meantime, instead of protecting the dysfunctional private insurance industry by diverting the debate to peripheral issues such as information technology, the politicians should tackle the most urgent problem head on. We need to fix the way we pay for health care so that everyone can have the care they need without facing financial hardship.