Evidence map›Paper›PMID 33823869›Full record

Observational studyBMC health services research2021

Adoption of a laboratory EMR system and inappropriate laboratory testing in Ontario: a cross-sectional observational study.

Nadine Chami, Silvy Mathew, Sharada Weir, James G Wright, Jasmin Kantarevic

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Nadine ChamiOntario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada. nadine.chami@oma.org.ORCID http://orcid.org/0000-0001-6760-2696
Silvy MathewMyFamilyMD, 396 St. Clair Ave. W, Toronto, ON, M5P 3N3, Canada.
Sharada WeirOntario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada.
James G WrightOntario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada.
Jasmin KantarevicOntario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada.
Ontario Medical Association · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElectronic medical record (EMR) systems have the potential to facilitate appropriate laboratory testing. We examined three common medical tests in primary care-hemoglobin A1c (HbA1c), lipid, and thyroid stimulating hormone (TSH)- to assess whether adoption of a laboratory EMR system in Ontario had an impact on the rate of inappropriate testing among primary care physicians.

methodsWe used FY2016-17 population-level laboratory data to estimate the association between adoption of a laboratory EMR system and the rate of inappropriate testing. Inappropriate testing was assessed based on recommendations for screening, monitoring, and follow-up that take into account risk factors related to patient age and certain clinical conditions. To overcome the problem of potential endogeneity of physician choice to use the EMR, the EMR penetration rate in the physician's geographical area of practice was used as an instrumental variable in an ordinary least squares (OLS) regression. We then simulated the change in the rate of inappropriate testing, by physician payment model, as the EMR penetration rate increased from the baseline percentage.

resultsThe simulation models showed that an increase in the rate of EMR penetration from a baseline average was associated with a statistically significant decrease in inappropriate hbA1c and lipid testing, but a statistically insignificant increase in inappropriate TSH testing. The impact of EMR penetration also varied by payment model.

conclusionsThis study demonstrated a positive association between availability of an EMR system and appropriate service utilization. Varying impacts of the EMR system availability by primary care payment model may be reflective of different incentives or attributes inherent in payment models. Policies to encourage physicians to increase their use of laboratory EMR systems could improve the quality and continuity of patient care.

Indexed as

Physicians, Primary CareDiagnostic Tests, RoutineElectronic Health RecordsHumansMedical OveruseOntarioPrimary Health CareEMRInappropriate laboratory testingPrimary care models

Identifiers

PMID33823869
PMCPMC8025377
OpenAlexW3140568773

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.