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Electronic Result Viewing and Quality of Care in Small Group Practices

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Journal of General Internal Medicine Aims and scope Submit manuscript

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.

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Acknowledgments

This work was funded by the Agency for Healthcare Research and Quality (grant).

Conflicts of Interest

Dr. Blair is the President of the 1 UC1 HS016316 Taconic IPA and the CEO of MedAllies. Dr. Salkowe and Ms. Chambers are employed by MVP Health Care; Dr. Salkowe is Vice President of Clinical Quality Improvement and Ms. Chambers is Director of Quality Improvement.

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Authors and Affiliations

  1. Department of Public Health, Weill Cornell Medical College, New York, NY, USA

    Lisa M. Kern MD, MPH, Yolanda Barrón MS, Mark A. Callahan MD & Rainu Kaushal MD, MPH

  2. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Lisa M. Kern MD, MPH & Mark A. Callahan MD

  3. New York-Presbyterian Hospital, New York, NY, USA

    Lisa M. Kern MD, MPH, Mark A. Callahan MD & Rainu Kaushal MD, MPH

  4. Taconic IPA, Fishkill, NY, USA

    A. John Blair III MD

  5. MedAllies, Fishkill, NY, USA

    A. John Blair III MD

  6. MVP Health Care, Schenectady, NY, USA

    Jerry Salkowe MD & Deborah Chambers

  7. Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA

    Rainu Kaushal MD, MPH

Authors
  1. Lisa M. Kern MD, MPH
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  2. Yolanda Barrón MS
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  3. A. John Blair III MD
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  4. Jerry Salkowe MD
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  5. Deborah Chambers
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  6. Mark A. Callahan MD
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  7. Rainu Kaushal MD, MPH
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Corresponding author

Correspondence to Lisa M. Kern MD, MPH.

Additional information

An earlier version of this work was presented at the national meeting of the Society of General Internal Medicine in Toronto, Ontario, Canada on April 27, 2007.

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Kern, L.M., Barrón, Y., Blair, A.J. et al. Electronic Result Viewing and Quality of Care in Small Group Practices. J GEN INTERN MED 23, 405–410 (2008). https://doi.org/10.1007/s11606-007-0448-1

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  • DOI: https://doi.org/10.1007/s11606-007-0448-1

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