title: Electronic medical record features and seven quality of care measures in physician offices.
abstract: The effect of electronic medical records (EMRs) on quality of care in physicians' offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care.
authors.affiliation: 1National Center for Health Statistics, Hyattsville, MD.
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Hsiao
authors.forename: Jill A
authors.initials: JA
authors.lastname: Marsteller
authors.forename: Alan E
authors.initials: AE
authors.lastname: Simon
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration / Q000592:standards; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D057286:Electronic Health Records / Q000458:organization & administration; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D010820:Physicians / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D017010:Reminder Systems; D012141:Respiratory Tract Infections / Q000188:drug therapy; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents
keywords: ambulatory care; electronic medical record; informatics; quality of health care