title: How does Canada stack up? A bibliometric analysis of the primary healthcare electronic medical record literature.
abstract: BACKGROUND
  Major initiatives are underway in Canada which are designed to increase electronic medical record (EMR) implementation and maximise its use in primary health care. These developments need to be supported by sufficient evidence from the literature, particularly relevant research conducted in the Canadian context.
  
  
  OBJECTIVE
  This study sought to quantify this lack of research by: (1) identifying and describing the primary health care EMR literature; and (2) comparing the Canadian and international primary healthcare EMR literature on the basis of content and publication levels.
  
  
  METHODS
  Seven bibliographic databases were searched using primary health care and EMR keywords. Publication abstracts were reviewed and categorised. First author affiliation was used to identify country of origin. Proportions of Canadian- and non-Canadian-authored publications were compared using Fisher's exact test. For countries having 10 or more primary healthcare EMR publications, publications per 10 000 researchers were calculated.
  
  
  RESULTS
  After exclusions, 750 publications were identified. More than one-third used primary healthcare EMRs as a study data source. Twenty-two (3%) were Canadian-authored. There were significantly different publication levels in three categories between Canadian- and non-Canadian-authored publications. Based on publications per researchers, the Netherlands ranked first, while Canada ranked eighth of nine countries with 10 or more publications.
  
  
  CONCLUSIONS
  A relatively small body of literature focused on EMRs in primary health care exists; publications by Canadian authors were low. This study highlights the need to develop a strong evidence base to support the effective implementation and use of EMRs in Canadian primary health care.
authors.affiliation: Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada. aterry4@uwo.ca
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Terry
authors.forename: Moira
authors.initials: M
authors.lastname: Stewart
authors.forename: Martin
authors.initials: M
authors.lastname: Fortin
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Wong
authors.forename: Maureen
authors.initials: M
authors.lastname: Kennedy
authors.forename: Fred
authors.initials: F
authors.lastname: Burge
authors.forename: Richard
authors.initials: R
authors.lastname: Birtwhistle
authors.forename: Inese
authors.initials: I
authors.lastname: Grava-Gubins
authors.forename: Greg
authors.initials: G
authors.lastname: Webster
authors.forename: Amardeep
authors.initials: A
authors.lastname: Thind
mesh_terms: D015706:Bibliometrics; D002170:Canada; D003219:Confidentiality; D003625:Data Collection / Q000379:methods* / Q000706:statistics & numerical data*; D057286:Electronic Health Records / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D007318:Inservice Training; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*