Practice systems for chronic care: frequency and dependence on an electronic medical record.
OBJECTIVE
To document the presence and functioning of different practice systems in a small sample of medical groups in Minnesota and to examine the relationship between the presence of practice systems and prior adoption of an electronic medical record (EMR).


METHODS
Descriptive study of the frequency of practice systems in 11 medical groups.


METHODS
We recruited 11 medical groups for the study. Four groups had an EMR; the other groups used paper medical records, often supplemented by electronic ordering or data systems. Using an on-site audit team, we validated the presence of practice systems organized under 8 categories.


RESULTS
All of the medical groups had implemented a substantial number of practice systems for care management of patients with chronic conditions. Although the medical groups with an EMR tended to have more comprehensive practice systems in place, the medical groups without an EMR also had most of the practice systems.


CONCLUSIONS
Although required in some functions, an EMR may not be necessary in facilitating practice systems that support consistent management of patients with chronic illness. Approaches are needed that will encourage the implementation of practice systems in medical groups with and without an EMR.
Solberg
Leif I
LI
HealthPartners Research Foundation, Minneapolis MN, USA. leif.i.solberg@healthpartners.com.
Scholle
Sarah Hudson
SH
Asche
Stephen E
SE
Shih
Sarah C
SC
Pawlson
L Gregory
LG
Thoele
Merry Jo
MJ
Murphy
Amy L R
AL
D000555:Ambulatory Care Information Systems / Q000706:statistics & numerical data*; D002908:Chronic Disease; D004059:Diffusion of Innovation; D006123:Group Practice / Q000458:organization & administration* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008910:Minnesota