ArticleJournal of the American Medical Informatics Association : JAMIA2016
Missing clinical and behavioral health data in a large electronic health record (EHR) system.
Article in Journal of the American Medical Informatics Association : JAMIA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 2 of them syntheses that pooled it.
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Who cites it
77 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Primary care physicians' attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework.BMC medical informatics and decision making · 2018Pooled it
- COVID-19-associated psychosis: A systematic review of case reports.General hospital psychiatryPooled it
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- Automatic phenotyping of emergency department patients with incidental hepatic steatosis: A machine learning clustering analysis.The American journal of emergency medicine · 2026Article
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- Are Difficult Inpatients Also Difficult Primary Care Patients?Journal of general internal medicine · 2026Article
- Bioethics and medical oversight in multi-site observational neuroimaging studies with children and adolescents: 10 years of ABCD experience.Developmental cognitive neuroscience · 2026Article
- Assessing the generalizability of prevalence estimates from the All of Us Research Program.American journal of epidemiology · 2026Article
- Pediatric precision sleep network: a study protocol for identifying sleep signatures of mental health risk in peri-adolescents.BMC pediatrics · 2026Article
- Validation of self‑harm prediction models among formerly incarcerated individuals using health data.Health & justice · 2026Article
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- Mental Health Symptom Screening Among Adult Emergency Department Patients: A Cross-Sectional Study.Journal of the American College of Emergency Physicians open · 2026Article
- A multidimensional hierarchical framework for sources of bias in real-world healthcare evidence: a scoping review.Journal of biomedical informatics · 2026Article
- Resources and applications of public biomedical data.Frontiers in bioinformatics · 2026Review
- A decade of designing and implementing electronic health records in Sub-Saharan Africa: a scoping review.Global health action · 2025Article
- Beyond Phecodes: leveraging PheMAP to identify patients lacking diagnosis codes in electronic health records.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Assessment and ascertainment in psychiatric molecular genetics: challenges and opportunities for cross-disorder research.Molecular psychiatry · 2025Review
- Generative AI Models in Time-Varying Biomedical Data: Scoping Review.Journal of medical Internet research · 2025Article
- Antipsychotic prescribing patterns in a state psychiatric hospital with predominantly forensic admissions.Frontiers in psychiatry · 2025Article
- Applications of Machine Learning on Electronic Health Record Data to Combat Antibiotic Resistance.The Journal of infectious diseases · 2024Review
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveRecent massive investment in electronic health records (EHRs) was predicated on the assumption of improved patient safety, research capacity, and cost savings. However, most US health systems and health records are fragmented and do not share patient information. Our study compared information available in a typical EHR with more complete data from insurance claims, focusing on diagnoses, visits, and hospital care for depression and bipolar disorder.
methodsWe included insurance plan members aged 12 and over, assigned throughout 2009 to a large multispecialty medical practice in Massachusetts, with diagnoses of depression (N = 5140) or bipolar disorder (N = 462). We extracted insurance claims and EHR data from the primary care site and compared diagnoses of interest, outpatient visits, and acute hospital events (overall and behavioral) between the 2 sources.
resultsPatients with depression and bipolar disorder, respectively, averaged 8.4 and 14.0 days of outpatient behavioral care per year; 60% and 54% of these, respectively, were missing from the EHR because they occurred offsite. Total outpatient care days were 20.5 for those with depression and 25.0 for those with bipolar disorder, with 45% and 46% missing, respectively, from the EHR. The EHR missed 89% of acute psychiatric services. Study diagnoses were missing from the EHR's structured event data for 27.3% and 27.7% of patients.
conclusionEHRs inadequately capture mental health diagnoses, visits, specialty care, hospitalizations, and medications. Missing clinical information raises concerns about medical errors and research integrity. Given the fragmentation of health care and poor EHR interoperability, information exchange, and usability, priorities for further investment in health IT will need thoughtful reconsideration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.