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Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance
Michelle Greiver1, Jan Barnsley, Richard H Glazier
1Department of Family and Community Medicine, University of Toronto, Ontario, Canada. mgreiver@rogers.com
Objective:
To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario's pay-for-performance program.
Design:
Prospective double-cohort study.
Participants:
Twenty-seven community-based family physicians.
Setting:
Toronto, Ont.
Intervention:
Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records.
Main Outcome Measure:
Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation.
Results:
After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval -2.8 to 3.9).
Conclusion:
When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied.
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