title: The impact of an integrated hospital-community medical information system on quality of care and medical service utilisation in primary-care clinics.
abstract: BACKGROUND
  In 2005, an innovative system of hospital-community, on-line medical records (OFEK) was introduced in Clalit Health Services (CHS).
  
  
  OBJECTIVE
  To examine OFEK's use and impact on quality indicators and medical-service utilisation in CHS primary-care clinics.
  
  
  METHODS
  Examining the frequency of OFEK's use with its own track-log data; comparing 'before' and 'after' quality indicators and service utilisation of experimental versus control clinics.
  
  
  RESULTS
  Use of OFEK increased by hundreds of percent between 2005 and 2006, continued rising at a slower rate in 2007 and decreased slightly in 2008. At clinics in catchment areas of hospitals using OFEK extensively, OFEK reduced the number of imaging tests and, to a lesser extent, laboratory testing and improved several quality measures. An examination of all clinics in the catchment areas and in the study revealed a much weaker impact.
  
  
  CONCLUSIONS
  OFEK's introduction affected a number of outcome measures - some, significantly - in medical and financial terms. Its increased use at additional clinics may exert a stronger impact there, too. The study contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems.
authors.affiliation: Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, JDC Hill, POB 3886, Jerusalem 91037, Israel. nuritn@jdc.org.il
authors.forename: Nurit
authors.initials: N
authors.lastname: Nirel
authors.forename: Bruce
authors.initials: B
authors.lastname: Rosen
authors.forename: Assaf
authors.initials: A
authors.lastname: Sharon
authors.forename: Hadar
authors.initials: H
authors.lastname: Samuel
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
mesh_terms: D019937:Diagnostic Techniques and Procedures / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D007256:Information Systems / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*