EMR users may not have an edge

NATIONAL REPORT - Results of a recently released study suggest that where quality of care is concerned - and despite the hype over recent years - physicians who use electronic medical records (EMR) have no significant edge over those who keep records the old-fashioned way: on paper.

Indeed, the study shows that doctors who keep paper records actually outperform their high-tech colleagues in one area: Paper-using doctors are 14 percentage points more likely to appropriately prescribe statins for patients with high cholesterol.

The study, based on data collected in 2003 and 2004 as part of the Centers for Disease Control and Prevention's National Ambulatory Care Survey, examined more than 50,000 patient records from more than 2,500 physician offices. In 14 of 17 guideline-based quality metrics, researchers found no statistically significant difference in quality of care between EMR and non-EMR practices.

"We wanted to see if we could take a look nationwide and see if the use of EMR really improves quality of care," he says.

Dr. Linder tells Dermatology Times that he and the study's co-authors are all advocates of EMR and that their findings do not necessarily refute previous studies' positive findings regarding EMR. He adds, however, that he wasn't surprised at his and his colleagues' findings.

"I would categorize our finding as disappointing but not surprising," he says. "The take-away message from our study is that EMRs are not magical systems - if you use the Microsoft Word equivalent of paper records, quality won't magically improve. I believe EMR is part of the solution for improving quality of care, not the solution."

"We use EMR, which efficiently connects our two New Jersey offices with our New York and Florida offices," says Dr. Goldberg, director of Skin Laser & Surgery Specialists of New York/New Jersey and clinical professor of dermatology at New York's Mount Sinai School of Medicine.

"I am not surprised by the study's findings," he says. "It is clear that EMR leads to the possibility of better quality of care, but EMR only provides the framework. Better quality of care is provided by the physician, not the computer program."

Study questioned

"This study is flawed," says Dr. Zachary, professor and chairman, department of dermatology, University of California, Irvine.