Colleagues,
A US study with similar findings to BEACH. Amazing what you find out
from the GPCG list if you press the right buttons.
I'm sure there'll be lots more to this debate. Both studies are looking
at quality.
What about safety? eg. incidence of adverse drug reactions, due to
interactions or allergy. These warnings have been long held to make
electronic prescribing safer.
The other question that comes to mind is the argument related to
micro-economic reform, which fits which our government's agenda for
electronic records, Medicare claiming, PBS updates, etc.
I wonder if computerised GPs are more efficient souls?
A study about this would be very interesting too.
Greg
-------- Original Message --------
Subject: [GPCG_TALK] More Grist To the Mill
Date: Wed, 11 Jul 2007 11:48:47 +1000
From: David More <[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED], General Practice Computing Group Talk
<[email protected]>
To: General Practice Computing Group Talk <[email protected]>
http://archinte.ama-assn.org/cgi/content/short/167/13/1400
Electronic Health Record Use and the Quality of Ambulatory Care in the
United States
Jeffrey A. Linder, MD, MPH; Jun Ma, MD, RD, PhD; David W. Bates, MD,
MSc; Blackford
Middleton, MD, MPH, MSc; Randall S. Stafford, MD, PhD
Arch Intern Med. 2007;167:1400-1405.
Background Electronic health records (EHRs) have been proposed as a
sustainable solution
for improving the quality of medical care. We assessed the association
between EHR use, as
implemented, and the quality of ambulatory care in a nationally
representative survey.
Methods We performed a retrospective, cross-sectional analysis of
visits in the 2003 and
2004 National Ambulatory Medical Care Survey. We examined EHR use
throughout the United
States and the association of EHR use with 17 ambulatory quality
indicators. Performance
on quality indicators was defined as the percentage of applicable visits
in which patients
received recommended care.
Results Electronic health records were used in 18% (95% confidence
interval [CI],
15%-22%) of the estimated 1.8 billion ambulatory visits (95% CI, 1.7-2.0
billion) in the
United States in 2003 and 2004. For 14 of the 17 quality indicators,
there was no
significant difference in performance between visits with vs without EHR
use. Categories
of these indicators included medical management of common diseases,
recommended antibiotic
prescribing, preventive counseling, screening tests, and avoiding
potentially
inappropriate medication prescribing in elderly patients. For 2 quality
indicators, visits
to medical practices using EHRs had significantly better performance:
avoiding
benzodiazepine use for patients with depression (91% vs 84%; P = .01)
and avoiding routine
urinalysis during general medical examinations (94% vs 91%; P = .003).
For 1 quality
indicator, visits to practices using EHRs had significantly worse
quality: statin
prescribing to patients with hypercholesterolemia (33% vs 47%; P = .01).
Conclusion As implemented, EHRs were not associated with better quality
ambulatory care.
Author Affiliations: Division of General Medicine, Brigham and Women's
Hospital and
Harvard Medical School, Boston, Massachusetts (Drs Linder, Bates, and
Middleton); and
Program on Prevention Outcomes and Practices, Stanford Prevention
Research Center,
Stanford University, Stanford, California (Drs Ma and Stafford). Dr Ma
is now with the
Department of Health Services Research, Palo Alto Medical Foundation
Research Institute,
Palo Alto, California.
----
Dr David G More MB, PhD, FACHI
Phone +61-2-9438-2851 Fax +61-2-9906-7038
Skype Username : davidgmore
E-mail: [EMAIL PROTECTED]
HealthIT Blog - www.aushealthit.blogspot.com
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
PRIVATE & CONFIDENTIAL
***********************************************************************
The information contained in this e-mail and their attached files,
including replies and forwarded copies, are confidential and intended
solely for the addressee(s) and may be legally privileged or prohibited
from disclosure and unauthorised use. If you are not the intended
recipient, any form of reproduction, dissemination, copying, disclosure,
modification, distribution and/or publication or any action taken or
omitted to be taken in reliance upon this message or its attachments is
prohibited.
All liability for viruses is excluded to the fullest extent permitted by
law.
***********************************************************************
_______________________________________________
Gpcg_talk mailing list
[email protected]
http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
_______________________________________________
Gpcg_talk mailing list
[email protected]
http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
