Electronic Health Records Can Measure Patient-Centered Care

The nonclinical data collected by electronic health records (EHR) could be used to measure the patient-centeredness of primary care practices, according to a new study.

Researchers at the Palo Alto Medical Foundation (Palo Alto, CA, USA) collected data on 15,370 patients with diabetes and 49,561 with hypertension who were treated at a large group practice in Northern California during 2010. They then examined the relationship between hemoglobin A1c, blood pressure (BP), and low density lipoprotein (LDL), and various nonclinical EHR information.

The results showed that the volume of secure electronic communications between physicians and patients, e-messages about patients within the practice, and time to the third-next-available appointment—a measure of how easy it is to schedule non-urgent visits—were reliable factors of primary care physicians (PCPs) processes of care. The volume of e-messages was associated with higher odds of LDL control among patients with diabetes. Frequent in-person visits were associated with better BP and LDL control among patients with diabetes, and better BP control among patients with hypertension. The study was published online on November 18, 2103, in Health Services Research.

“These nonclinical data are the type often evaluated by those looking at how well a large practice operates, but had not necessarily been linked to a clinical outcome,” said lead author Ming Tai-Seale, PhD, MPH. “The reason we also looked at process-of-care measures-emailing, e-messages with staff, and continuity of care-is because these have not been used to study their linkages with patient health outcomes before.”

The EHR is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. In the EHR are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR has the ability to automate and streamline the clinician's workflow by generating a complete record of a clinical patient encounter, including evidence-based decision support, quality management, and outcomes reporting.

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Palo Alto Medical Foundation