Understanding, evaluating and enhancing electronic medical record adoption in a primary care setting




Bowen, Michael

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Full service family physicians in British Columbia (BC) are claiming financial incentives in return for providing enhanced care for patients with chronic diseases. These same physicians are also being actively encouraged to adopt electronic medical record systems (EMRs) with an expectation that their adoption will, among other things, aid in improved chronic disease management (CDM). Indeed, both incentives and clinical information systems have been demonstrated in the literature to be crucial components in effective CDM programs. However, within BC little evidence is available that demonstrates whether EMR adoption is in fact associated with improved provision of CDM services. Furthermore, it is not well understood how the CDM incentive program affects a family practice’s adoption of CDM-related EMR functionality. Through a mixed methods study the relationship between EMR adoption and CDM incentives in a small family practice is explored. Additionally, an audit and feedback intervention is used to test the hypothesis that both incentive use and EMR adoption can simultaneously be improved. Results of the study suggest that the presence of an EMR may not guarantee improvements in delivery of incentivized CDM services; that the incentive program has limits in its ability to promote adoption of CDM-related EMR features; and, that a program of audit and feedback may promote improvements in aspects of EMR adoption and incentive utilization.



Electronic Medical Record, EMR, Electronic Medical Record Adoption, EMR Adoption, Data Quality, Incentive, Chronic Disease Management