Study: EMRs Improve Ambulatory Care

A new study done by researchers from the Weill Cornell Medical College has concluded that community-based physicians who move to EMRs can improve care meaningfully.

The study, which was done in collaboration with New York’s Health Information Technology Collaborative, gathered baseline year data gathered from 500+ physicians in ambulatory practices and 75,000 patients with five different health plans in New York’s Hudson Valley.  They then compared quality scores for EMR-using physicians and those without EMRs.

Researchers concluded that 56 percent of physicians who were using EMRs scored significantly higher on quality of care provided, particularly in managing chlamydia, diabetes, colorectal cancer and breast cancer.  A combined score across nine quality measures also also suggested that EMRs helped generated better care than paper-based records overall.

What made the study results particularly interesting, researchers said, was that the physicians using EMRs used off-the-shelf systems which hadn’t been specialized to achieve these kind of results.

Researchers seem to think that the improved ambulatory results are just the tip of the iceberg:

EHRs may improve the quality of care by making information more accessible to physicians, providing medical decision-making support in real time and allowing patients and providers to communicate regularly and securely,” says Dr. Rainu Kaushal, director of the Center for Healthcare Informatics and Policy and the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell. “However, the real value of these systems is their ability to organize data and to allow transformative models of health care delivery, such as the patient-centered medical home, to be layered on top.” 

Interesting. I would have assumed that reminders and warnings had generated , as they certainly help doctors make sure overworked doctors are on target with tests, avoid drug interactions and the like. But researchers like Dr. Kaushal and her colleagues seem to think that the big EMR payoff will come as EMR systems change the core models doctors use to deliver care.

Given that new models are all but inevitable at this point, I guess we’ll get to find out!