title: Electronic medical record system at an opioid agonist treatment programme: study design, pre-implementation results and post-implementation trends.
abstract: BACKGROUND
  Electronic medical record (EMR) systems are commonly included in health care reform discussions. However, their embrace by the health care community has been slow.
  
  
  METHODS
  At Addiction Research and Treatment Corporation, an outpatient opioid agonist treatment programme that also provides primary medical care, HIV medical care and case management, substance abuse counselling and vocational services, we studied the implementation of an EMR in the domains of quality, productivity, satisfaction, risk management and financial performance utilizing a prospective pre- and post-implementation study design.
  
  
  RESULTS
  This report details the research approach, pre-implementation findings for all five domains, analysis of the pre-implementation findings and some preliminary post-implementation results in the domains of quality and risk management. For quality, there was a highly statistically significant improvement in timely performance of annual medical assessments (P < 0.001) and annual multidiscipline assessments (P < 0.0001). For risk management, the number of events was not sufficient to perform valid statistical analysis.
  
  
  CONCLUSIONS
  The preliminary findings in the domain of quality are very promising. Should the findings in the other domains prove to be positive, then the impetus to implement EMR in similar health care facilities will be advanced.
authors.affiliation: Division of Medical Services, Research and Information Technology, Addiction Research and Treatment Corporation, Brooklyn, NY 11201, USA. skritz@artcny.org
authors.forename: Steven
authors.initials: S
authors.lastname: Kritz
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Brown
authors.forename: Melissa
authors.initials: M
authors.lastname: Chu
authors.forename: Carlota
authors.initials: C
authors.lastname: John-Hull
authors.forename: Charles
authors.initials: C
authors.lastname: Madray
authors.forename: Roberto
authors.initials: R
authors.lastname: Zavala
authors.forename: Ben
authors.initials: B
authors.lastname: Louie
mesh_terms: D004059:Diffusion of Innovation; D057286:Electronic Health Records / Q000458:organization & administration*; D006801:Humans; D009293:Opioid-Related Disorders / Q000188:drug therapy; D019982:Organizational Case Studies; D009939:Organizations, Nonprofit; D016730:Program Development; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012107:Research Design; D012308:Risk Management; D016320:Substance Abuse Treatment Centers