The use of electronic health records (EHRs) is not necessarily related to the quality of ambulatory care, according to a report published in the July 9 issue of Archives of Internal Medicine.
In a restrospective analysis of approximately 1.8 billion ambulatory visits in the 2003 and 2004 National Ambulatory Medical Care Survey, researchers assessed the association between EHR use and 17 ambulatory quality indicators, including medical management of common diseases, recommended antibiotic prescribing, preventive counseling, screening tests, and avoiding potentially inappropriate medication prescribing in elderly patients. Performance on these indicators was defined as the percentage of applicable visits in which patients received recommended care.
EHRs were used in 18 percent of the visits analyzed. According to the report, for 14 of the 17 quality indicators, there was no significant difference in performance between visits with versus without EHR use. For two of the indicators, visits to medical practices using EHRs had significantly better performance--avoiding benzodiazepine use for patients with depression, and avoiding routine urinalysis during general medical examinations. However, for one indicator (statin prescribing to patients with hypercholesterolemia), visits showed significantly worse quality. Read the abstract.
