title: Electronic health records and health care quality over time in a federally qualified health center.
abstract: The longitudinal effects of electronic health records (EHRs) on ambulatory quality are not clear. It is not known whether adoption and meaningful use of EHRs result in a brief period of quality improvement that then plateaus, or whether with ongoing use quality improvement continues. We studied health care quality at six sites of a Federally Qualified Health Center in New York State over 3 years (2008-2010) for 25 290 unique patients. Patients were twice as likely to receive recommended care on a set of 12 quality measures (11 of which are included in Stage 1 Meaningful Use) 3 years post-EHR implementation, compared to 1-year post-implementation (odds ratio 1.97; 95% confidence interval, 1.91-2.03). The magnitude of absolute improvement ranged from 5% to 20% per measure. EHRs were associated with continuing improvement in health care quality for at least 3 years post-implementation in the safety-net setting of a Federally Qualified Health Center.
authors.affiliation: Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, USA Department of Medicine, Weill Cornell Medical College, New York, USA lmk2003@med.cornell.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kern
authors.affiliation: Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, USA.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Edwards
authors.affiliation: Institute for Family Health, New York, NY, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Pichardo
authors.affiliation: Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, USA Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, USA Department of Medicine, Weill Cornell Medical College, New York, USA Department of Pediatrics, Weill Cornell Medical College, New York, USA New York-Presbyterian Hospital, New York, USA.
authors.forename: Rainu
authors.initials: R
authors.lastname: Kaushal
mesh_terms: D000328:Adult; D000368:Aged; D057286:Electronic Health Records / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D062527:Meaningful Use; D008875:Middle Aged; D009518:New York; D011787:Quality of Health Care / Q000639:trends*; D064876:Safety-net Providers / Q000639:trends*
keywords: electronic health records; quality of health care; safety-net providers