Ability to generate patient registries among practices with and without electronic health records.
BACKGROUND
The ability to generate registries of patients with particular clinical attributes, such as diagnoses or medications taken, is central to measuring and improving the quality of health care. However, it is not known how many providers have the ability to generate such registries.


OBJECTIVE
To assess the proportion of physician practices that can construct registries of patients with specific diagnoses, laboratory results, or medications, and to determine the relationship between electronic health record (EHR) usage and the ability to perform registry functions.


METHODS
We conducted a mail survey of a stratified random sample of physician practices in Massachusetts in the northeastern United States (N = 1884). The survey included questions about the physicians' ability to generate diagnosis, laboratory result, and medication registries; the presence of EHR; and usage of specific EHR features.


RESULTS
The response rate was 71% (1345/1884). Overall, 79.8% of physician practices reported being able to generate registries of patients by diagnosis; 56.1% by laboratory result; and 55.8% by medication usage. In logistic regression analyses, adjusting for urban/rural location, practice size and ownership, teaching status, hospital affiliation, and specialty, physician practices with an EHR were more likely to be able to construct diagnosis registries (adjusted odds ratio [OR] 1.53, 95% confidence interval [CI] 1.25 - 1.86), laboratory registries (OR 1.42, 95% CI 1.22 - 1.66), and medication registries (OR 2.30, 95% CI 1.96 - 2.70).


CONCLUSIONS
Many physician practices were able to generate registries, but this capability is far from universal. Adoption of EHRs appears to be a useful step toward this end, and practices with EHRs are considerably more likely to be able to carry out registry functions. Because practices need registries to perform broad-based quality improvement, they should consider adopting EHRs that have built-in registry functionality.
Wright
Adam
A
Clinical Informatics Research & Development, Partners Healthcare System, Boston, MA, USA. awright5@partners.org
McGlinchey
Elizabeth A
EA
Poon
Eric G
EG
Jenter
Chelsea A
CA
Bates
David W
DW
Simon
Steven R
SR
D002908:Chronic Disease; D004582:Electronics, Medical; D005194:Family Practice / Q000458:organization & administration; D006306:Health Surveys; D006801:Humans; D008404:Massachusetts; D008499:Medical Records; D016347:Medical Records Systems, Computerized; D016017:Odds Ratio; D010820:Physicians; D011785:Quality Assurance, Health Care; D012042:Registries; D012044:Regression Analysis; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population
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