Journal of General Internal Medicine

, Volume 23, Issue 4, pp 405–410

Electronic Result Viewing and Quality of Care in Small Group Practices

  • Lisa M. Kern
  • Yolanda Barrón
  • A. John BlairIII
  • Jerry Salkowe
  • Deborah Chambers
  • Mark A. Callahan
  • Rainu Kaushal
Original Article

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 

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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Lisa M. Kern
    • 1
    • 2
    • 3
  • Yolanda Barrón
    • 1
  • A. John BlairIII
    • 4
    • 5
  • Jerry Salkowe
    • 6
  • Deborah Chambers
    • 6
  • Mark A. Callahan
    • 1
    • 2
    • 3
  • Rainu Kaushal
    • 1
    • 3
    • 7
  1. 1.Department of Public HealthWeill Cornell Medical CollegeNew YorkUSA
  2. 2.Department of Medicine, Weill Cornell Medical CollegeNew YorkUSA
  3. 3.New York-Presbyterian HospitalNew YorkUSA
  4. 4.Taconic IPAFishkillUSA
  5. 5.MedAlliesFishkillUSA
  6. 6.MVP Health CareSchenectadyUSA
  7. 7.Department of Pediatrics, Weill Cornell Medical CollegeNew YorkUSA

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