Electronic health records can help improve the quality of care that doctors are delivering, but not without a steady dose of assistance, according to a recently released study. Researchers at Weill Cornell Medical College and the Primary Care Information Project found that results didn't come overnight, either, as primary practices needed both high levels of technical assistance and nearly a year of exposure to an EHR to start bolstering quality.
Since 2007, the New York City Department of Health and Mental Hygiene has been helping practices to adopt EHRs as part of the Primary Care Information Project. Thus far, more than 3,000 physicians in 600 practices have enrolled, equaling the largest community-based EHR implementation project. A key component, according to the study, was continued on-site technical assistance — including everything from troubleshooting to improving the health of a population of patients, interfacing the patient registry and generating quality reports.
Weill Cornell observed doctors in the project, and compared them to Physicians in New York State outside of the project, who weren't receiving assistance. Researchers found that just giving doctors electronic records wasn't enough to tug quality scores upward, and assistance is essential in the one-two punch of improved care.
Other finds in the study:
- Implementing EHRs within the Primary Care Information Project was associated with improved quality in a set of measures related to breast cancer screening, retinal exam and urine testing for patients with diabetes, chlamydia screening for women, and colorectal cancer screening.
- Only doctors who received high levels of technical assistance with EHR use improved quality, even in cases where physicians were using the records for two years or with moderate levels of help,according to the study.
- Even with high levels of technical assistance, it took at least nine months of using the EHR to start seeing quality gains.