Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov 11;6(4):669-76.
doi: 10.4338/ACI-2015-05-RA-0062. eCollection 2015.

Does an Electronic Health Record Improve Completeness of Prenatal Studies?

T A McLean  1 , A K Lewkowitz  2 , E Test  2 , M G Zlatnik  2
Affiliations

Does an Electronic Health Record Improve Completeness of Prenatal Studies?

T A McLean et al. Appl Clin Inform. .

Abstract

Objective: To determine whether implementation of an electronic health record (EHR) would increase the rate of prenatal Human Immunodeficiency Virus (HIV) and purified protein derivative (PPD) testing.

Methods: Eligible participants received prenatal care and delivered at term at a single academic institution in March-April 2011, March-April 2012, and March-April 2013. As part of routine prenatal care, all women were tested for HIV and tuberculosis (via a PPD test) during each pregnancy. The 2011 cohort was charted on paper. The 2012 and 2013 cohorts were charted via EHR. To appear in the prenatal labs display in EHR, PPD results must be manually documented, while HIV results are uploaded automatically. Documentation of PPD and HIV tests were analyzed.

Results: The 2011, 2012, and 2013 cohorts had 249, 208, and 190 patients, respectively. Complete PPD and HIV results were less likely to be charted in the 2012 EHR cohort compared to the paper chart cohort (72.1% vs. 80.1%; p=0.03). This was driven by fewer documented completed PPD tests (2011 83.9% vs. 2012 72.6%; p=0.003). PPD test documentation improved non-significantly to 86.2% in the 2013 EHR cohort (p=0.5). HIV documentation rates increased from 95.2% in the paper chart cohort to 98.6% in the 2012 EHR cohort (p=0.04), and to 98.9% in the 2013 EHR cohort (p=0.03).

Conclusions: EHR implementation corresponded with a marked decrease in documentation of PPD test completion. HIV documentation rates improved. PPD results were likely charted incorrectly in provider notes due to training deficiencies and lack of standardization, which did not improve significantly after retraining.

Keywords: Electronic health record; prenatal care.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

The authors report no conflict of interest. There was no source of financial support for this study, nor funding from any organization.

Figures

Fig. 1
Fig. 1
Completion rates of documented purified protein derivative (PPD) and Human Immunodeficiency Virus (HIV) results in the 2011 paper chart cohort (blue); the 2012 electronic health record cohort (red); and the 2013 electronic health record cohort, after retraining (green).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Blumenthal D. Stimulating the adoption of health information technology. New Engl J Med 2009; 360(15):1477–1479. - PubMed
    1. Metz JP, Son SJ, Winter RO, Chae S. Increasing timely and available prenatal studies by electronic health records. J Am Board Fam Med 2011; 24(4):344–350. - PubMed
    1. Persell SD, Kaiser D, Dolan NC, Andrews B, Levi S, Khandekar J, Gavagan T, Thompson JA, Friesema EM, Baker DW. Changes in performance after implementation of a multifaceted electronic-health-record based quality improvement system. Med Care 2011; 49(2):117–125. - PubMed
    1. Varroud-Vial M. Improving diabetes management with electronic medical records. Diabetes Metab 2011; 37(Suppl 4): S48-S52. - PubMed
    1. Eden KB, Messina R, Li H, Osterweil P, Henderson CR, Guise JM. Examining the value of electronic health records on labor and delivery. Am J Obstet Gynecol 2008; 199(3): 307 e1–e9. - PubMed