Impact of electronic medical record on physician practice in office settings: a systematic review
Date
2012-02-24
Authors
Lau, Francis
Price, Morgan
Boyd, Jeanette
Partridge, Colin
Bell, Heidi
Raworth, Rebecca
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Increased investments are being made for electronic medical records (EMRs) in Canada. There is a
need to learn from earlier EMR studies on their impact on physician practice in office settings. To address this
need, we conducted a systematic review to examine the impact of EMRs in the physician office, factors that
influenced their success, and the lessons learned.
Results: For this review we included publications cited in Medline and CINAHL between 2000 and 2009 on
physician office EMRs. Studies were included if they evaluated the impact of EMR on physician practice in office
settings. The Clinical Adoption Framework provided a conceptual scheme to make sense of the findings and allow
for future comparison/alignment to other Canadian eHealth initiatives.
In the final selection, we included 27 controlled and 16 descriptive studies. We examined six areas: prescribing
support, disease management, clinical documentation, work practice, preventive care, and patient-physician
interaction. Overall, 22/43 studies (51.2%) and 50/109 individual measures (45.9%) showed positive impacts, 18.6%
studies and 18.3% measures had negative impacts, while the remaining had no effect. Forty-eight distinct factors
were identified that influenced EMR success. Several lessons learned were repeated across studies: (a) having
robust EMR features that support clinical use; (b) redesigning EMR-supported work practices for optimal fit; (c)
demonstrating value for money; (d) having realistic expectations on implementation; and (e) engaging patients in
the process.
Conclusions: Currently there is limited positive EMR impact in the physician office. To improve EMR success one
needs to draw on the lessons from previous studies such as those in this review.
Description
BioMed Central
Keywords
Citation
Lau et al.: Impact of electronic medical record on physician practice in office settings: a systematic review. BMC Medical Informatics and Decision Making 2012 12:10.