title: [OFEK virtual medical records: an evaluation of an integrated hospital-community system].
abstract: BACKGROUND
  In 2005, an innovative system of hospital-community on-line medical records ("OFEK") was established at Clalit Health Services to reduce costs and improve medical care.
  
  
  OBJECTIVE
  To examine the utilization of OFEK and its impact on quality indicators and medical-service utilization.
  
  
  METHODS
  Examining frequency of use of OFEK with OFEK's own track-log data; "before" and "after" data were used to compare changes in quality indicators and service utilization for experimental versus control groups.
  
  
  RESULTS
  Use of OFEK in primary-care clinics increased by hundreds of percent from 2005 to 2006 and continued rising in 2007 and 2008, albeit more slowly. At clinics in hospital catchment areas using OFEK extensively, the system reduced utilization of imaging services and, to a lesser extent laboratory use, and improved several quality measures. Analyses of the data from all catchment areas and from all study clinics revealed much weaker effects. In hospitals, the use of OFEK increased by tens of percent each year internal medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in surgical wards.
  
  
  CONCLUSIONS
  The introduction of OFEK affected some of the outcome measures examined. OFEK affects community clinics and hospital wards differently, with more consistent effects in the community.
  
  
  CONCLUSIONS
  The study helps assess the extent to which OFEK's targets were achieved. In addition, it contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of electronic-medical-information systems.
authors.affiliation: Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute. 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: Orna
authors.initials: O
authors.lastname: Blondheim
authors.forename: Michael
authors.initials: M
authors.lastname: Sherf
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D057286:Electronic Health Records / Q000191:economics / Q000458:organization & administration; D006751:Hospital Information Systems / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007557:Israel; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care