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The effects of an Electronic Medical Record on patient care: clinician attitudes in a large HMO

OBJECTIVE
The purpose of this study is to examine the attitudes of clinicians in a large HMO toward the effect of an outpatient Electronic Medical Record system on the quality of patient care. Attitudes toward a Results Reporting system and an online charting and ordering system are also compared.


DESIGN
A cross-sectional study was performed using a survey of Kaiser Permanente Northwest clinicians. In addition, interviews were conducted with the physician leaders of the clinical departments at Kaiser Permanente Northwest.


MEASUREMENTS
Clinician attitudes are measured regarding the effects of a Results Reporting system and an online charting and ordering system on the overall quality of patient care and other care-related indices.


RESULTS
Most clinicians feel that the outpatient Electronic Medical Record has improved the overall quality of patient care, with 72% reporting an improvement with the use of the Results Reporting system, and 60% reporting an improvement with the use of the online charting and ordering system. On average, clinicians feel that the EMR has also improved the quality of the patient-clinician interaction, the ability to coordinate the care of patients with other departments, the ability to detect medication errors, the timeliness of referrals, and the ability to act on test results in a timely fashion.


CONCLUSION
Clinicians perceive an improvement in patient care as a result of using an outpatient Electronic Medical Record system. Clinicians have higher opinions, however, of the effects of a Results Reporting system compared to an online charting and ordering system.