Implementation of an electronic medical record does not change delivery of preventive care for HIV-positive patients.
OBJECTIVE
This study sought to determine the impact that an electronic medical record (EMR) had on the provision of preventive health measures - including obtaining serologies for viral hepatitis and administering vaccinations to non-immune patients - to HIV patients at a hospital-based clinic.


METHODS
Using a pre-post study design, we compared rates of preventive health delivery to HIV patients at an outpatient clinic during the use of a paper medical record (PMR) and after implementation of an EMR. Retrospective chart reviews were conducted at two time points: 12-16 months prior to and 24 months following EMR implementation. The records of 160 active patients were randomly selected for review during both time periods.


RESULTS
There was no difference between the PMR and EMR samples with regard to the proportion of patients who had hepatitis A (83% in PMR group; 77% in EMR) and hepatitis C (94% in both groups) serologies measured or the proportion of eligible patients who were given hepatitis vaccinations. Slightly fewer patients had a serology for hepatitis B measured in the EMR sample.


CONCLUSIONS
As EMR implementation expands, it is important to evaluate the effects that EMRs have on patient outcomes, including preventive health provision. Our study showed that after implementation of an EMR, the provision of most preventive care measures did not improve. This finding is in agreement with many published studies. Some studies have found positive effects from EMRs that may be attributable to specific aspects of EMRs. Further study of the effect of specific EMR attributes on health care outcomes is needed.
Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Medicine, Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: apetroll@mcw.edu.
Andrew E
AE
Petroll
Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA.
Jenise K
JK
Phelps
Department of Medicine, Division of General Internal Medicine, College of Wisconsin, Milwaukee, WI, USA; Department of Medicine, Clement J Zablocki VA Medical Center, Milwaukee, WI, USA.
Kathlyn E
KE
Fletcher
D000328:Adult; D003695:Delivery of Health Care; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000472:pathogenicity*; D015658:HIV Infections / Q000517:prevention & control* / Q000821:virology; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D011314:Preventive Health Services; D011379:Prognosis; D012189:Retrospective Studies
HIV; Medical records systems, computerized; Physicians’ practice patterns; Preventive health services; Reminder systems