Electronic Health Records can be used to measure and improve patient-centered care.

Electronic health records (EHRs) are mainly used to store patient clinical data. However, a new study says that the non-clinical information EHRs collect can be used to assess patient-doctor interaction and determine how that may impact patient care.

The study, published by Health Behavior News of the U.S. non-profit Center for Advancing Health, was conducted by researchers from California’s Palo Alto Medical Foundation Research Institute and the University of Minnesota. They aimed to assess the reliability of data in EHRs for measuring the processes of care among primary care physicians and to examine the relationship between these measures and clinical outcomes.

“We were looking for ways to leverage the amount of operational information in a practice’s EHR and find measurements of the process of care. We were pleasantly surprised to see we could do that,” said Ming Tai-Seale, Ph.D., MPH, senior staff scientist at Palo Alto Medical Foundation, and lead study author.

To draw this conclusion, the team collected EHR data on 49,561 people with high blood pressure and 15,370 with diabetes who were all patients at a large group practice in Northern California during 2010. The clinical data collected included blood glucose and blood lipid levels and blood pressure readings. Then the researchers examined the relationship between that clinical information and various nonclinical types of EHR information, including the volume of secure electronic communication (e-messages) between physicians and patients; e-messages about patients within the practice; and the time to the third-next-available appointment ― a measure of how easy it is to schedule non-urgent visits.

They found that all three were reliable factors of physician processes of care. The patient outreach also seemed to affect clinical outcomes. For instance, more in-person visits were associated with better blood pressure control in hypertension patients, and better cholesterol and blood pressure control were associated with more frequent messaging to diabetic patients.

Bottom line, tangible information on the relationship between doctors and patients already exists in EHRs. A different way to tap that information could help patients control their high blood pressure.

The study didn’t find evidence of a cause and effect between operational activities and clinical outcomes and they agree that the topic deserves further research.


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