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
Date
01/21/2014Pubmed ID
24440204Pubmed Central ID
PMC4371786DOI
10.1016/j.ijmedinf.2013.12.005Scopus ID
2-s2.0-84896735684 (requires institutional sign-in at Scopus site) 1 CitationAbstract
PURPOSE: This study sought to determine the impact that an electronic medical record (EMR) had on the provision of preventive health measures - including obtaining serologies for viral hepatitis and administering vaccinations to non-immune patients - to HIV patients at a hospital-based clinic.
METHODS: Using a pre-post study design, we compared rates of preventive health delivery to HIV patients at an outpatient clinic during the use of a paper medical record (PMR) and after implementation of an EMR. Retrospective chart reviews were conducted at two time points: 12-16 months prior to and 24 months following EMR implementation. The records of 160 active patients were randomly selected for review during both time periods.
RESULTS: There was no difference between the PMR and EMR samples with regard to the proportion of patients who had hepatitis A (83% in PMR group; 77% in EMR) and hepatitis C (94% in both groups) serologies measured or the proportion of eligible patients who were given hepatitis vaccinations. Slightly fewer patients had a serology for hepatitis B measured in the EMR sample.
CONCLUSIONS: As EMR implementation expands, it is important to evaluate the effects that EMRs have on patient outcomes, including preventive health provision. Our study showed that after implementation of an EMR, the provision of most preventive care measures did not improve. This finding is in agreement with many published studies. Some studies have found positive effects from EMRs that may be attributable to specific aspects of EMRs. Further study of the effect of specific EMR attributes on health care outcomes is needed.
Author List
Petroll AE, Phelps JK, Fletcher KEAuthors
Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of WisconsinAndrew Petroll MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultDelivery of Health Care
Female
Follow-Up Studies
HIV
HIV Infections
Health Plan Implementation
Humans
Male
Medical Records Systems, Computerized
Middle Aged
Preventive Health Services
Prognosis
Retrospective Studies
