JAMIA: Preventive care better controlled with EHRs

Despite challenges in data transmission, continued use of EHRs to track population health is important in demonstrating the value of health IT adoption and improving the quality of care in the primary care setting, based on a commentary published in the Journal of the American Medical Informatics Association, posted online Aug. 19.

The commentary focused on work done by the Primary Care Information Project (PCIP), a New York City initiative that works to improve population health through preventive care that can reduce avoidable deaths and complications from chronic conditions. The PCIP, which represents approximately 25 percent of the 9,000 primary care providers in New York City that serve an estimated two million patients, assisted more than 300 primary care practices in adopting of a fully functional EHR. Practices with EHRs can transmit summary data to PCIP for tracking population health indicators in preventive care.

The study’s author, Samantha F. De Leon, PhD, a research scientist with PCIP and with the New York City Department of Health and Mental Hygiene, and colleagues said early data analysis focusing on the smaller practices—those with less than 10 providers serving Medicaid and uninsured populations—showed that use of an EHR increased the delivery of recommended preventive services.

The advantage of using EHRs to track population health include accessing information quicker and utilizing data sources to reduce additional expenditures for data collection. In addition, patient data can be aggregated or summarized to generate rates of preventive care through the use of secured information networks.

Through a competitive procurement process, PCIP selected eClinicalWorks, a commercial EHR software vendor, to co-develop a prevention-oriented EHR that allows providers to measure and report their rates of preventive care. Practices adopting the EHR receive electronic reminders, a quality-of-care reporting tool and health-promoting services, as well as the ability to transmit preventive care data summaries to the PCIP.

Although EHRs are expected to improve the efficiency of the healthcare system, the quality of care and safety of patients, their adoption rates remain fairly low in the U.S., according to the authors.

Only about 13 to 25 percent of providers nationwide use a basic EHR and only 4 percent use a fully functional EHR, which includes electronic reminders, computerized provider order entry or drug alerts. As more providers adopt EHRs and fully integrate health IT into their daily routines, additional opportunities for assessing the impact of preventive services in the ambulatory primary care setting will be identified.