Int J Med Inform - Implementation of an electronic medical record does not change delivery of preventive care for HIV-positive patients.

Tópicos

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Resumo

RPOSE: This study sought to determine the impact that an electronic medical record (EMR) had on the provision of preventive health measures - including obtaining serologies for viral hepatitis and administering vaccinations to non-immune patients - to HIV patients at a hospital-based clinic.METHODS: Using a pre-post study design, we compared rates of preventive health delivery to HIV patients at an outpatient clinic during the use of a paper medical record (PMR) and after implementation of an EMR. Retrospective chart reviews were conducted at two time points: 12-16 months prior to and 24 months following EMR implementation. The records of 160 active patients were randomly selected for review during both time periods.RESULTS: There was no difference between the PMR and EMR samples with regard to the proportion of patients who had hepatitis A (83% in PMR group; 77% in EMR) and hepatitis C (94% in both groups) serologies measured or the proportion of eligible patients who were given hepatitis vaccinations. Slightly fewer patients had a serology for hepatitis B measured in the EMR sample.CONCLUSIONS: As EMR implementation expands, it is important to evaluate the effects that EMRs have on patient outcomes, including preventive health provision. Our study showed that after implementation of an EMR, the provision of most preventive care measures did not improve. This finding is in agreement with many published studies. Some studies have found positive effects from EMRs that may be attributable to specific aspects of EMRs. Further study of the effect of specific EMR attributes on health care outcomes is needed.

Resumo Limpo

rpose studi sought determin impact electron medic record emr provis prevent health measur includ obtain serolog viral hepat administ vaccin nonimmun patient hiv patient hospitalbas clinicmethod use prepost studi design compar rate prevent health deliveri hiv patient outpati clinic use paper medic record pmr implement emr retrospect chart review conduct two time point month prior month follow emr implement record activ patient random select review time periodsresult differ pmr emr sampl regard proport patient hepat pmr group emr hepat c group serolog measur proport elig patient given hepat vaccin slight fewer patient serolog hepat b measur emr sampleconclus emr implement expand import evalu effect emr patient outcom includ prevent health provis studi show implement emr provis prevent care measur improv find agreement mani publish studi studi found posit effect emr may attribut specif aspect emr studi effect specif emr attribut health care outcom need

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