Are family physicians comprehensively using electronic medical records such that the data can be used for secondary purposes? A Canadian perspective.
BACKGROUND
With the introduction and implementation of a variety of government programs and policies to encourage adoption of electronic medical records (EMRs), EMRs are being increasingly adopted in North America. We sought to evaluate the completeness of a variety of EMR fields to determine if family physicians were comprehensively using their EMRs and the suitability of use of the data for secondary purposes in Ontario, Canada.


METHODS
We examined EMR data from a convenience sample of family physicians distributed throughout Ontario within the Electronic Medical Record Administrative data Linked Database (EMRALD) as extracted in the summer of 2012. We identified all physicians with at least one year of EMR use. Measures were developed and rates of physician documentation of clinical encounters, electronic prescriptions, laboratory tests, blood pressure and weight, referrals, consultation letters, and all fields in the cumulative patient profile were calculated as a function of physician and patient time since starting on the EMR.


RESULTS
Of the 167 physicians with at least one year of EMR use, we identified 186,237 patients. Overall, the fields with the highest level of completeness were for visit documentations and prescriptions (>70%). Improvements were observed with increasing trends of completeness overtime for almost all EMR fields according to increasing physician time on EMR. Assessment of the influence of patient time on EMR demonstrated an increasing likelihood of the population of EMR fields overtime, with the largest improvements occurring between the first and second years.


CONCLUSIONS
All of the data fields examined appear to be reasonably complete within the first year of adoption with the biggest increase occurring the first to second year. Using all of the basic functions of the EMR appears to be occurring in the current environment of EMR adoption in Ontario. Thus the data appears to be suitable for secondary use.
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. karen.tu@ices.on.ca.|Department of Family and Community Medicine, University of Toronto, Toronto, Canada. karen.tu@ices.on.ca.|University Health Network-Toronto Western Family Health Team, Toronto, Canada. karen.tu@ices.on.ca.
Karen
K
Tu
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Jessica
J
Widdifield
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Jacqueline
J
Young
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
William
W
Oud
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.|Department of Family and Community Medicine, University of Toronto, Toronto, Canada.|Women's College Research Institute and Family Practice Health Centre, Women's College Hospital, Toronto, Canada.
Noah M
NM
Ivers
Department of Family and Community Medicine, University of Toronto, Toronto, Canada.|Department of Family and Community Medicine-The Scarborough Hospital, Toronto, Canada.
Debra A
DA
Butt
Canada Health Infoway, Toronto, Canada.
Chad A
CA
Leaver
Institute for Clinical Evaluative Sciences, G1 06, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.|Department of Family and Community Medicine, University of Toronto, Toronto, Canada.|Department of Family and Community Medicine-Sunnybrook Health Sciences Centre, Toronto, Canada.
Liisa
L
Jaakkimainen
D000328:Adult; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D008498:Medical Record Linkage; D009864:Ontario; D010821:Physicians, Family / Q000706:statistics & numerical data*