title: Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment.
abstract: OBJECTIVE
  To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario's pay-for-performance program.
  
  
  METHODS
  Prospective double-cohort study.
  
  
  METHODS
  Twenty-seven community-based family physicians.
  
  
  METHODS
  Toronto, Ont.
  
  
  METHODS
  Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records.
  
  
  METHODS
  Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation.
  
  
  RESULTS
  After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval -2.8 to 3.9).
  
  
  CONCLUSIONS
  When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied.
authors: Department of Family and Community Medicine, University of Toronto, Ontario, Canada. mgreiver@rogers.com
authors: Michelle
authors: M
authors: Greiver
authors: Jan
authors: J
authors: Barnsley
authors: Richard H
authors: RH
authors: Glazier
authors: Rahim
authors: R
authors: Moineddin
authors: Bart J
authors: BJ
authors: Harvey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario; D010821:Physicians, Family / Q000458:organization & administration*; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D012052:Reimbursement, Incentive / Q000191:economics*; D011795:Surveys and Questionnaires; D055815:Young Adult