In response to Andis Robeznieks' "Vendors dispute EHR, ambulatory-care report":
I am no vendor and I agree that the original article Electronic Health Record Use and the Quality of Ambulatory Care in the United States was a surface-level analysis report, and its publication in a prestigious journal such as the Archives of Internal Medicine, did leave many clinical professionals (the normal clientele of the journal) with an opinion that the time spent in use of EHR is a wasteas the article written by eminent academics concludes that: "As implemented, EHRs were not associated with better quality ambulatory care."
Your report with vendor response has presented explanations based on small sample size or time of data (2003).
Any explanation as such should come from the authors; this request should be based on the fact that the EHR as such is a data-collection tool, it is not in itself a decision-support tool. It must have an integrated decision-support module for alerts, reminders and guidelines for any quality assurance to be observed. I have two suggestions:
One, the authors would serve the profession well if they explained the presence or absence of decision-support modules in the systems "as implemented."
Two, completeness of records could support decisionmaking: If the authors were to analyze the data stratifying the records of patients with multiple visits vs. patients with single encounters, then perhaps there may be some chance for a statistical correlation to completeness in data to positive interventions for quality assurance.
Khalid Moidu, M.D.Information services administrationOrlando Regional HealthcareOrlando, Fla. To submit a letter to YOUR VIEWS, click here. Please include your name, title and hometown.