Electronic health records by themselves may not be enough to drive significant quality improvement at physician practices, according to a new study in Annals of Internal Medicine.
The prospective cohort study analyzed care quality among similar primary care practices in New York's Hudson Valley over the course of three years. Researchers compared quality measures at 13 practices that used EHRs and transitioned into patient-centered medical homes during the study period with 64 practices that used EHRs but did not become PCMHs and 235 practices that did not become PCMHs and remained paper-based.
The researchers found the largest quality gains among the practices that used EHRs and transitioned to PCMHs. These practices scored significantly higher than the other practices in four of the 10 quality measures used by the researchers to assess performance, and researchers concluded the likelihood of a patient receiving recommended care was 6 percent higher in the PCMHs than in practices that just used EHRs.
"The study showed that primary care physicians participating in PCMHs improved their quality of care over time at a significantly higher rate than their non-PCMH peers," said lead author Lisa Kern, MD, an associate professor of healthcare policy and research at Weill Cornell Medical College in New York City, in a news release. "The PCMH model combines EHRs with organizational changes, including changes in the roles and responsibilities of clinicians and staff. It was the combination of EHRs plus organizational changes that was associated with the greatest quality improvement; EHRs alone were not enough."
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