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Electronic Medical Record Availability and Primary Care Depression Treatment

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ABSTRACT

Background

Electronic medical records (EMR) are commonly believed to improve quality of care. Primary care patients with multiple chronic conditions have potentially greater opportunity to benefit from receiving care at practices with EMRs if these systems help coordinate complex care.

Objective

To examine how chronic conditions impact the odds that depressed patients receive depression treatment in primary care practices with EMRs compared to practices without EMRs.

Design

The study uses logistic regression to analyze cross-sectional data of primary care physician office visits in freestanding, office-based practices from the 2006–2008 National Ambulatory Medical Care Surveys.

Patients

All visits to primary care providers made by patients ages 18 and older with physician-identified depression (N = 3,467).

Main Measures

Outcomes include depression treatment which is defined as receipt or ordering of antidepressant medication and/or mental health counseling.

Key Results

EMRs were associated with significantly lowered odds that depressed patients received depression treatment (OR = 0.75, p = 0.009, 95% CI: 0.61-0.93); however when stratified by the number of chronic conditions, this association was observed only in patients with three or more chronic conditions (OR = 0.50, p > 0.001, 95% CI: 0.36-0.70). EMRs did not have a significant association with depression treatment for patients with two or fewer chronic conditions.

Conclusions

EMRs appear to have an unintended negative association with depression care provided during visits made by primary care patients with multiple chronic conditions.

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ACKNOWLEDGEMENTS

There were no funding sources for this research. This research was presented at the AcademyHealth Annual Research Meeting, Seattle, WA, June 12, 2011.

Conflict of Interest

The authors declare that they do not have any conflicts of interest to report.

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Authors and Affiliations

  1. Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA

    Jeffrey S. Harman PhD & Christopher A. Harle PhD

  2. Department of Mental Health Law and Policy, Florida Mental Health Institute, University of South Florida, Tampa, FL, USA

    Kathryn M. Rost PhD

  3. Department of Epidemiology and Department of Medicine, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA

    Robert L. Cook MD, MPH

Authors
  1. Jeffrey S. Harman PhD
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  2. Kathryn M. Rost PhD
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  3. Christopher A. Harle PhD
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  4. Robert L. Cook MD, MPH
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Corresponding author

Correspondence to Jeffrey S. Harman PhD.

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Harman, J.S., Rost, K.M., Harle, C.A. et al. Electronic Medical Record Availability and Primary Care Depression Treatment. J GEN INTERN MED 27, 962–967 (2012). https://doi.org/10.1007/s11606-012-2001-0

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  • DOI: https://doi.org/10.1007/s11606-012-2001-0

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