Electronic Records Boost Quality Of Care

Electronic Records Boost Quality Of Care

New research from Case Western Reserve University School of Medicine shows recent federal investments in electronic health records are already paying off.

In a study of Cleveland-area physician offices, researchers found better patient outcomes and higher quality of care in practices that use electronic health records compared with those that use paper records, regardless of what kind of insurance patients had.

The research was led by Randall D. Cebul, MD, professor of medicine and epidemiology and biostatistics at the School of Medicine and director of the Case Western Reserve University/ MetroHealth Medical Center’s Center for Health Care Research and Policy. The study involved more than 27,000 adult diabetes patients seeing more than 500 primary care physicians at 46 practices that are partners in a region-wide collaborative known as Better Health Greater Cleveland, which Cebul directs. The Better Health study tracked data over a 12-month span between 2009 and 2010, and also followed trends over a threeyear period.

The study measured quality of care by a set of locally vetted national standards including timely measurements of blood sugar, management of kidney problems, eye examinations and vaccinations for pneumonia. Outcome measures included meeting national benchmarks for blood sugar, blood pressure and cholesterol control, as well as achieving a non-obese Body Mass Index and avoiding tobacco use.

Nearly 51 percent of patients in practices using electronic records received care that met all of the endorsed standards. Only 7 percent of patients at paper-based practices received the same level of care. In addition, nearly 44 percent of patients in electronic record practices met at least four of five outcome standards, while 16 percent of patients at paperbased practices had comparable results. Following trends over time, practices using electronic records showed greater annual improvements—both in quality of care and in patient outcomes—than paper-based practices.

The results, published in the New England Journal of Medicine, spanned all insurance types, including patients insured by Medicare and Medicaid, as well as the uninsured.