Original Article

Journal of General Internal Medicine

, Volume 23, Issue 4, pp 405-410

First online:

Electronic Result Viewing and Quality of Care in Small Group Practices

  • Lisa M. KernAffiliated withDepartment of Public Health, Weill Cornell Medical CollegeDepartment of Medicine, Weill Cornell Medical CollegeNew York-Presbyterian Hospital Email author 
  • , Yolanda BarrónAffiliated withDepartment of Public Health, Weill Cornell Medical College
  • , A. John BlairIIIAffiliated withTaconic IPAMedAllies
  • , Jerry SalkoweAffiliated withMVP Health Care
  • , Deborah ChambersAffiliated withMVP Health Care
  • , Mark A. CallahanAffiliated withDepartment of Public Health, Weill Cornell Medical CollegeDepartment of Medicine, Weill Cornell Medical CollegeNew York-Presbyterian Hospital
  • , Rainu KaushalAffiliated withDepartment of Public Health, Weill Cornell Medical CollegeNew York-Presbyterian HospitalDepartment of Pediatrics, Weill Cornell Medical College

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Abstract

Background

There is a paucity of data on the effectiveness of commercially available electronic systems for improving health care in office practices, where the majority of health care is delivered. In particular, the effect of electronic laboratory result viewing on quality of care, including preventive care, chronic disease management, and patient satisfaction, is unclear.

Objective

To determine whether electronic laboratory result viewing is associated with higher ambulatory care quality.

Methods

We conducted a cross-sectional study of primary care physicians (PCPs) in the Taconic IPA in New York, all of whom have the opportunity to use a free-standing electronic portal for laboratory result viewing. We analyzed 15 quality measures, reflecting preventive care, chronic disease management, and patient satisfaction, which were collected in 2005. Using generalized estimating equations, we determined associations between portal usage and quality, adjusting for adoption of electronic health records and 10 other physician characteristics, including case mix.

Main Results

One-third of physicians (54/168, 32%) used the portal at least once over a 6-month period. Use of the portal was associated with higher quality overall (adjusted odds ratio [OR] 1.25; 95% confidence interval [CI] 1.003, 1.57). In stratified analyses, portal usage was associated with higher quality on those performance measures expected to be impacted by result viewing (adjusted OR 1.34; 95% CI 1.00, 1.81; p = 0.05), but not associated with quality for measures not expected to be impacted by result viewing (adjusted OR 1.03; 95% CI 0.72, 1.48; p = 0.85).

Conclusion

Electronic laboratory result viewing was independently associated with higher ambulatory care quality. Longitudinal studies are needed to confirm this association.

KEY WORDS

health information technology health information exchange quality of health care laboratory results