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Electronic Health Records Shows No Improvement in Quality of Outpatient Care

In two quality areas - not prescribing benzodiazepine tranquilizers for patients with depression, and avoiding routine urinalysis during general medical exams - doctors using electronic record systems fared better than those who didn't. But when it came to prescribing statins for patients with high cholesterol, physicians using electronic systems did worse.

Electronic health record systems have become a centerpiece in the quest to improve the quality of health care. By storing a patient's medical history in electronic form, such systems can eliminate errors due to bad handwriting, make it easier to follow patient information over time and enable physicians to easily share patients' records.

Additionally, the more sophisticated systems can flag potential problems, such as mixing medications that might trigger a bad reaction, and provide advice about which tests to order or which medications to prescribe.

Past studies have assessed the use of electronic health records in hospitals, where patients are acutely ill and quality issues can have life-threatening consequences. But relatively little research has examined the performance of electronic health records in outpatient settings, Stafford said.

However, much of today's health care is delivered during visits to clinics or doctors' offices, so it's important to know whether the electronic systems are producing better outcomes, he added.

For the study, Stafford and his colleagues drew their data from the National Ambulatory Medical Care Survey, a survey conducted by the National Center of Health Statistics that provides information on patient visits to office-based physician practices.

The researchers found that electronic health records were used in 18 percent of the estimated 1.8 billion physician visits that occurred in 2003 and 2004. Using a previously defined set of 17 quality indicators for ambulatory care developed by the S
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