Electronic result viewing and quality of care in small group practices.
BACKGROUND
There is a paucity of data on the effectiveness of commercially available electronic systems for improving health care in office practices, where the majority of health care is delivered. In particular, the effect of electronic laboratory result viewing on quality of care, including preventive care, chronic disease management, and patient satisfaction, is unclear.


OBJECTIVE
To determine whether electronic laboratory result viewing is associated with higher ambulatory care quality.


METHODS
We conducted a cross-sectional study of primary care physicians (PCPs) in the Taconic IPA in New York, all of whom have the opportunity to use a free-standing electronic portal for laboratory result viewing. We analyzed 15 quality measures, reflecting preventive care, chronic disease management, and patient satisfaction, which were collected in 2005. Using generalized estimating equations, we determined associations between portal usage and quality, adjusting for adoption of electronic health records and 10 other physician characteristics, including case mix.


RESULTS
One-third of physicians (54/168, 32%) used the portal at least once over a 6-month period. Use of the portal was associated with higher quality overall (adjusted odds ratio [OR] 1.25; 95% confidence interval [CI] 1.003, 1.57). In stratified analyses, portal usage was associated with higher quality on those performance measures expected to be impacted by result viewing (adjusted OR 1.34; 95% CI 1.00, 1.81; p = 0.05), but not associated with quality for measures not expected to be impacted by result viewing (adjusted OR 1.03; 95% CI 0.72, 1.48; p = 0.85).


CONCLUSIONS
Electronic laboratory result viewing was independently associated with higher ambulatory care quality. Longitudinal studies are needed to confirm this association.
Kern
Lisa M
LM
Department of Public Health, Weill Cornell Medical College, New York, NY 10021, USA. lmk2003@med.cornell.edu
Barrón
Yolanda
Y
Blair
A John
AJ
Salkowe
Jerry
J
Chambers
Deborah
D
Callahan
Mark A
MA
Kaushal
Rainu
R
D000328:Adult; D002984:Clinical Laboratory Information Systems; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006123:Group Practice / Q000592:standards; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D009518:New York; D016017:Odds Ratio; D010821:Physicians, Family; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care