Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis

Background Electronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their proper use benefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of...

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Main Authors: Noura Hamade, Amanda Terry, Monali Malvankar-Mehta
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Health & Care Informatics
Online Access:https://informatics.bmj.com/content/26/1/e000023.full
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author Noura Hamade
Amanda Terry
Monali Malvankar-Mehta
author_facet Noura Hamade
Amanda Terry
Monali Malvankar-Mehta
author_sort Noura Hamade
collection DOAJ
description Background Electronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their proper use benefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of care; 3) reduced errors and 4) more involved patients. The use of EMRs is defined by practitioners using EMRs and their features to perform daily practice functions.Objective The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary healthcare settings.Methods Ten online databases were searched to identify studies conducted in primary healthcare settings aimed at implementing interventions to observe the use of EMRs and directly measure the use of EMR functions or outcomes effected by the use of EMR functions.Results Of 2098 identified studies, 12 were included in the review. Results showed that interventions focused on the use of EMR functions, including referrals, electronic communication, reminders, use of clinical decision support systems and workflow management support functions, were five times more likely to show improvements in EMR use compared with controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared with controls.Conclusions Individuals in primary healthcare settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons such as clinical decision support systems and customised referral templates, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality.
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spelling doaj-art-16c04ff6caa14bca9941878be5b1c6602025-08-20T02:11:29ZengBMJ Publishing GroupBMJ Health & Care Informatics2632-10092019-12-0126110.1136/bmjhci-2019-000023Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysisNoura Hamade0Amanda Terry1Monali Malvankar-Mehta2Centre for Global Health, Dalla Lana School of Public Health, Toronto, Ontario, CanadaDepartment of Epidemiology and Biostatistics, Western University Schulich School of Medicine & Dentistry, London, Ontario, CanadaDepartment of Ophthalmology, Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, CanadaBackground Electronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their proper use benefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of care; 3) reduced errors and 4) more involved patients. The use of EMRs is defined by practitioners using EMRs and their features to perform daily practice functions.Objective The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary healthcare settings.Methods Ten online databases were searched to identify studies conducted in primary healthcare settings aimed at implementing interventions to observe the use of EMRs and directly measure the use of EMR functions or outcomes effected by the use of EMR functions.Results Of 2098 identified studies, 12 were included in the review. Results showed that interventions focused on the use of EMR functions, including referrals, electronic communication, reminders, use of clinical decision support systems and workflow management support functions, were five times more likely to show improvements in EMR use compared with controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared with controls.Conclusions Individuals in primary healthcare settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons such as clinical decision support systems and customised referral templates, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality.https://informatics.bmj.com/content/26/1/e000023.full
spellingShingle Noura Hamade
Amanda Terry
Monali Malvankar-Mehta
Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
BMJ Health & Care Informatics
title Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
title_full Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
title_fullStr Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
title_full_unstemmed Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
title_short Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
title_sort interventions to improve the use of emrs in primary health care a systematic review and meta analysis
url https://informatics.bmj.com/content/26/1/e000023.full
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