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    Monday, June 1, 2009

    EMR vs. no EMR

    Will Electronic medical records in the doctors office improve quality medical care.

    The last time I looked there still was as yet no desirable uniform system for all physicians.

    Data from more than 50,000 patient records in more than 2,500 practices over two years showed that comparing physicians who used an electronic medical record with those who didn't produced only a handful of statistically significant differences on quality-of-care metrics. The figures show in what percentage of relevant cases each type of practice adhered to some commonly accepted quality guidelines.

    Quality indicator EMR No EMR
    Antithrombotic therapy for atrial fibrillation 54% 60%
    Aspirin use for coronary artery disease 45% 40%
    Beta-blocker use for coronary artery disease 40% 38%
    Diuretic and beta-blocker use for hypertension 64% 60%
    Statin use* 33% 47%
    Inhaled corticosteroid use for asthma 44% 44%
    Treatment of depression 82% 86%
    No benzodiazepine use for depression* 91% 84%
    Selected antibiotic use for acute otitis media 68% 67%
    Smoking cessation counseling 30% 23%
    Diet counseling for high-risk adults 28% 33%
    Exercise counseling for high-risk adults 20% 21%
    Blood pressure check 68% 71%
    No routine electrocardiogram 97% 96%
    No routine urinalysis* 94% 91%
    No routine hemoglobin/hematocrit 86% 86%
    Avoiding potentially inappropriate prescribing in elderly patients 93% 93%
    * Statistically significant

    Source: "Electronic Health Record Use and the Quality of Ambulatory Care in the United States," by Jeffrey A. Linder, MD, MPH, et al., July 9 Archives of Internal Medicinecq whole thing.

    2 comments:

    1. Those who continue to use quality measures to sell EMR software make me laugh. I think there could be some long term quality measures that benefit from broad adoption of EMR, but I don't see that being measurable for a long time to come.

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