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Electronic medical records and primary care quality: Evidence from Manitoba
Author(s) -
Rodriguez Llorian Elisabet,
Mason Gregory
Publication year - 2021
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.4249
Subject(s) - medical record , ambulatory care , medicine , quality (philosophy) , health care , quality management , family medicine , electronic medical record , primary care , population health , population , medline , medical emergency , environmental health , business , marketing , philosophy , epistemology , service (business) , political science , law , economics , radiology , economic growth
Improvements in quality of care through supporting decision‐making processes and increased efficiency have prompted widespread implementation of electronic medical records (EMRs) in Canada. Using a set of indicators of preventive care, chronic disease management, and hospitalizations due to ambulatory care sensitive conditions (ACSC), this study measures the effect of EMR adoption on quality of primary care measures. Population‐based data for the Canadian province of Manitoba are used in a difference‐in‐differences approach with patient‐ and time‐fixed effects. Evidence of changes in the selected quality‐of‐care indicators is weak, with preventive care, management of asthma, and hospitalizations showing no significant change due to EMR adoption. A statistically significant increase in the quality of diabetes care was found for EMR users, changes being larger for late EMR adopters which is possibly explained by a network effect. This research demonstrates that measuring whether EMRs prompt changes in the quality of care confronts serious challenges. The rapid evolution and gradual adoption of EMR technology, the inevitable learning/acceptance process by individual health practitioners, and its potential reflection on different patient populations create unmeasurable variables that confound EMRs' impact. This study also underscores the importance of data development to support the economic value of EMRs.