title: The impact of the electronic medical record on structure, process, and outcomes within primary care: a systematic review of the evidence.
abstract: BACKGROUND
  The electronic medical record (EMR)/electronic health record (EHR) is becoming an integral component of many primary-care outpatient practices. Before implementing an EMR/EHR system, primary-care practices should have an understanding of the potential benefits and limitations.
  
  
  OBJECTIVE
  The objective of this study was to systematically review the recent literature around the impact of the EMR/EHR within primary-care outpatient practices.
  
  
  METHODS
  Searches of Medline, EMBASE, CINAHL, ABI Inform, and Cochrane Library were conducted to identify articles published between January 1998 and January 2010. The gray literature and reference lists of included articles were also searched. 30 studies met inclusion criteria.
  
  
  CONCLUSIONS
  The EMR/EHR appears to have structural and process benefits, but the impact on clinical outcomes is less clear. Using Donabedian's framework, five articles focused on the impact on healthcare structure, 21 explored healthcare process issues, and four focused on health-related outcomes.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada. jayna.holroyd-leduc@albertahealthservices.ca
authors.forename: Jayna M
authors.initials: JM
authors.lastname: Holroyd-Leduc
authors.forename: Diane
authors.initials: D
authors.lastname: Lorenzetti
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
authors.forename: Lindsay
authors.initials: L
authors.lastname: Sykes
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D057286:Electronic Health Records; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States