Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If You Use a Screen Reader

This content is available through Read Online (Free) program, which relies on page scans. Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.

Effect Of Electronic Health Records In Ambulatory Care: Retrospective, Serial, Cross Sectional Study

Terhilda Garrido, Laura Jamieson, Yvonne Zhou, Andrew Wiesenthal and Louise Liang
BMJ: British Medical Journal
Vol. 330, No. 7491 (Mar. 12, 2005), pp. 581-584
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25459143
Page Count: 4
  • Read Online (Free)
  • Subscribe ($19.50)
  • Cite this Item
Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Effect Of Electronic Health Records In Ambulatory Care: Retrospective, Serial, Cross Sectional Study
Preview not available

Abstract

Objective To evaluate the effect of implementing comprehensive, integrated electronic health record systems on use and quality of ambulatory care Design Retrospective, serial, cross sectional study. Setting Colorado and Northwest regions of Kaiser Permanente, a US integrated healthcare delivery system. Population 367 795 members in the Colorado region and 449 728 members in the Northwest region. Intervention Implementation of electronic health record systems. Main outcome measures Total number of office visits and use of primary care, specialty care, clinical laboratory, radiology services, and telephone contact. Health Plan Employer Data and Information Set to assess quality. Results Two years after electronic health records were fully implemented, age adjusted rates of office visits fell by 9% in both regions. Age adjusted primary care visits decreased by 11% in both regions and specialty care visits decreased by 5% in Colorado and 6% in the Northwest. All these decreases were significant (P < 0.0001). The percentage of members making ≥3 visits a year decreased by 10% in Colorado and 11% in the Northwest, and the percentage of members with ≤2 visits a year increased. In the Northwest, scheduled telephone contact increased from a baseline of 1.26 per member per year to 2.09 after two years. Use of clinical laboratory and radiology services did not change conclusively. Intermediate measures of quality of health care remained unchanged or improved slightly. Conclusions Readily available, comprehensive, integrated clinical information reduced use of ambulatory care while maintaining quality and allowed doctors to replace some office visits with telephone contacts. Shifting patterns of use suggest reduced numbers of ambulatory care visits that are inappropriate or marginally productive.

Page Thumbnails

  • Thumbnail: Page 
581
    581
  • Thumbnail: Page 
582
    582
  • Thumbnail: Page 
583
    583
  • Thumbnail: Page 
584
    584