papers

Implementation of electronic medical records: effect on the provision of preventive services in a pay-for-performance environment

Can Fam Physician 57:e381-e389.

Department of Family and Community Medicine, University of Toronto, ON, Canada

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.

PMID: 21998246
PMCID: PMC3192104