Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment
- PMID: 21998246
- PMCID: PMC3192104
Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment
Abstract
Objective: To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario's pay-for-performance program.
Design: Prospective double-cohort study.
Participants: Twenty-seven community-based family physicians.
Setting: Toronto, Ont.
Intervention: Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records.
Main outcome measure: Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation.
Results: After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval -2.8 to 3.9).
Conclusion: When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied.
Objectif: Vérifier l’effet de la mise en œuvre des dossiers médicaux électroniques (DMÉ) sur les services de prévention couverts par le programme ontarien de rémunération au rendement.
Type d’étude: Étude prospective à double cohorte.
Participants: Vingt-sept médecins de famille pratiquant en milieu communautaire.
Contexte: Toronto, Ontario.
Interventions: Dix-huit médecins avaient adopté les DMÉ alors que les 9 autres continuaient d’utiliser les dossiers papier.
Principaux paramètres à l’étude: Effet du programme incitatif de rémunération au rendement sur la prestation de 4 services préventifs (tests de Papanicolaou, dépistage par mammographies, recherche du sang occulte dans les selles et vaccination contre la grippe) au cours des 2 ans suivant l’introduction des DMÉ.
Résultats: Après ajustement, l’ensemble des services préventifs pour le groupe DMÉ a augmenté de 0,7 %, une augmentation inférieure à celle observée pour le groupe non DMÉ (P = 0,55, intervalle de confiance à 95 % −2,8 à 3,9).
Conclusion: Par rapport aux dossiers papiers, la mise en œuvre des DMÉ n’a pas eu d’effet significatif sur la prestation des 4 services préventifs étudiés.
Figures
Similar articles
-
Measuring data reliability for preventive services in electronic medical records.BMC Health Serv Res. 2012 May 14;12:116. doi: 10.1186/1472-6963-12-116. BMC Health Serv Res. 2012. PMID: 22583552 Free PMC article.
-
Implementation of electronic medical records: theory-informed qualitative study.Can Fam Physician. 2011 Oct;57(10):e390-7. Can Fam Physician. 2011. PMID: 21998247 Free PMC article.
-
Implementation of an electronic medical record does not change delivery of preventive care for HIV-positive patients.Int J Med Inform. 2014 Apr;83(4):273-7. doi: 10.1016/j.ijmedinf.2013.12.005. Epub 2013 Dec 27. Int J Med Inform. 2014. PMID: 24440204 Free PMC article. Clinical Trial.
-
Pay-for-performance incentives for preventive care: views of family physicians before and after participation in a reminder and recall project (P-PROMPT).Can Fam Physician. 2011 Jun;57(6):690-6. Can Fam Physician. 2011. PMID: 21673219 Free PMC article.
-
Feedback and training tool to improve provision of preventive care by physicians using EMRs: a randomised control trial.Inform Prim Care. 2011;19(3):147-53. doi: 10.14236/jhi.v19i3.807. Inform Prim Care. 2011. PMID: 22688223 Clinical Trial.
Cited by
-
Health Information Technology Acceptance Framework for diabetes management.Heliyon. 2019 May 27;5(5):e01735. doi: 10.1016/j.heliyon.2019.e01735. eCollection 2019 May. Heliyon. 2019. PMID: 31193710 Free PMC article.
-
Demandes concurrentielles et possibilités en soins primaires.Can Fam Physician. 2017 Sep;63(9):e371-e376. Can Fam Physician. 2017. PMID: 28904046 Free PMC article. French. No abstract available.
-
Measuring data reliability for preventive services in electronic medical records.BMC Health Serv Res. 2012 May 14;12:116. doi: 10.1186/1472-6963-12-116. BMC Health Serv Res. 2012. PMID: 22583552 Free PMC article.
-
Implementation of electronic medical records: theory-informed qualitative study.Can Fam Physician. 2011 Oct;57(10):e390-7. Can Fam Physician. 2011. PMID: 21998247 Free PMC article.
-
Autoimmune haemolytic anaemia due to immunodeficiency.BMJ Case Rep. 2022 Nov 22;15(11):e250074. doi: 10.1136/bcr-2022-250074. BMJ Case Rep. 2022. PMID: 36414334 Free PMC article.
References
-
- Canada Health Infoway . Annual report 2007–2008. The evolution of health care: making a difference. Toronto, ON: Canada Health Infoway; 2008. Available from: www2.infoway-inforoute.ca/Documents/Infoway_Annual_Report_2007-2008_Eng.pdf. Accessed 2011 Sep 9.
-
- American recovery and reinvestment act of 2009, Pub L No. 111-5, 123 Stat 115-531. Available from: www.gpo.gov/fdsys/pkg/PLAW-111publ5/pdf/PLAW-111publ5.pdf. Accessed 2011 Sep 9.
-
- The health of Canadians—the federal role. Final report. Volume 6: recommendations for reform. Ottawa, ON: Standing Senate Committee on Social Affairs, Science and Technology; 2002. Available from: www.parl.gc.ca/Content/SEN/Committee/372/soci/rep/repoct02vol6-e.htm. Accessed 2011 Sep 9.
-
- Romanow RJ. Building on values: the future of health care in Canada. Ottawa, ON: Commission of the Future of Health Care in Canada; 2002. Available from: http://dsp-psd.pwgsc.gc.ca/Collection/CP32-85-2002E.pdf. Accessed 2011 Sep 9.
-
- Ministry of Health and Long-Term Care . Family Health Network agreement. Toronto, ON: Ministry of Health and Long-Term Care; 2005. IT appendix. Physician IT program.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
