Feedback and training tool to improve provision of preventive care by physicians using EMRs: a randomised control trial.
BACKGROUND
Electronic medical records (EMRs) have the potential to improve the provision of preventive care by allowing general practitioners (GPs) to track and recall eligible patients and record testing for feedback on their service provision.


OBJECTIVE
This study  evaluates the effect of an educational intervention and feedback tool designed to teach GPs how to use their EMRs to improve their provision of preventive care.


METHODS
A randomised controlled trial comparing rates of mammography, Papanicolaou tests, faecal occult blood tests and  albumin creatinine ratios one-year pre- and post-intervention was conducted. Nine primary care practices (PCPs) representing over 30 000 patients were paired by practice size and experience of GPs, and randomly allocated to intervention or control groups. Physicians at the four intervention  practices received a two-hour feedback session on their current level of preventive care and training to generate eligible patient lists for preventive services from their EMR database.


RESULTS
One-year post-intervention results provided no evidence of a difference. The intervention  was not a significant predictor of the one-year postintervention test rates for any of the four tests. On average, the intervention practices increased postintervention test rates on all tests by 16.8%, and control practices increased by 22.3%.


CONCLUSIONS
The non-significant results  may be due to a variety of reasons, including the level of intensity of the educational intervention, the cointervention of a government programme which provided incentives to GPs meeting specific targets for preventive care testing or the level of recording of tests performed in the EMR.
DELPHI Project, Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, Canada. hlmaddoc@uwo.ca
Heather
H
Maddocks
Moira
M
Stewart
Amardeep
A
Thind
Amanda L
AL
Terry
Vijaya
V
Chevendra
J Neil
JN
Marshall
Louisa Bestard
LB
Denomme
Sonny
S
Cejic
D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000458:organization & administration* / Q000706:statistics & numerical data; D005246:Feedback; D058005:General Practitioners / Q000193:education*; D006801:Humans; D007318:Inservice Training / Q000379:methods* / Q000458:organization & administration; D008327:Mammography / Q000706:statistics & numerical data; D009780:Occult Blood; D011314:Preventive Health Services / Q000458:organization & administration*; D014626:Vaginal Smears / Q000706:statistics & numerical data