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The impact of the electronic medical record on structure,process, and outcomes within primary care: a systematic review of the evidence
Authors:Jayna M Holroyd-Leduc  Diane Lorenzetti  Sharon E Straus  Lindsay Sykes  Hude Quan
Affiliation:1.Department of Medicine, University of Calgary, Calgary, Alberta, Canada;2.Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada;3.Centre for Health and Policy Studies, University of Calgary, Calgary, Alberta, Canada;4.Department of Medicine, University of Toronto and St. Michael''s Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada;5.Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
Abstract:

Background

The electronic medical record (EMR)/electronic health record (EHR) is becoming an integral component of many primary-care outpatient practices. Before implementing an EMR/EHR system, primary-care practices should have an understanding of the potential benefits and limitations.

Objective

The objective of this study was to systematically review the recent literature around the impact of the EMR/EHR within primary-care outpatient practices.

Materials and methods

Searches of Medline, EMBASE, CINAHL, ABI Inform, and Cochrane Library were conducted to identify articles published between January 1998 and January 2010. The gray literature and reference lists of included articles were also searched. 30 studies met inclusion criteria.

Results and discussion

The EMR/EHR appears to have structural and process benefits, but the impact on clinical outcomes is less clear. Using Donabedian''s framework, five articles focused on the impact on healthcare structure, 21 explored healthcare process issues, and four focused on health-related outcomes.
Keywords:Clinical informatics   quality of healthcare   systematic review   machine learning   health data standards   vocabulary   ontology   scientific information and health data policy   consumer health/patient education information   information retrieval   NLP   public health informatics   clinical trials   electronic medical records   primary care   systematic review
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