title: Practice systems for chronic care: frequency and dependence on an electronic medical record.
abstract: 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.
authors.affiliation: HealthPartners Research Foundation, Minneapolis MN, USA. leif.i.solberg@healthpartners.com.
authors.forename: Leif I
authors.initials: LI
authors.lastname: Solberg
authors.forename: Sarah Hudson
authors.initials: SH
authors.lastname: Scholle
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Asche
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Shih
authors.forename: L Gregory
authors.initials: LG
authors.lastname: Pawlson
authors.forename: Merry Jo
authors.initials: MJ
authors.lastname: Thoele
authors.forename: Amy L R
authors.initials: AL
authors.lastname: Murphy
mesh_terms: 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