ReviewJMIR medical informatics2021
The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review.
Review in JMIR medical informatics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Electronic health records: managerial insights from an umbrella review.BMC health services research · 2026Pooled it
- Nested order panels for adult primary care modestly improves ordering efficiency among high utilizers.JAMIA open · 2026Article
- Mixed methods evaluation of a clinical decision support system to reduce variation in healthcare.NPJ digital medicine · 2025Article
- Understanding Unwarranted Variation in Care for Victorian Oesophagogastric Cancer Patients Using Linked Data: A Comparative Analysis Between 2012-2016 and 2017-2021.ANZ journal of surgery · 2025Article
- Developing a SNOMED CT-Based Value Set to Document Symptoms and Diagnoses for Adverse Drug Events: Mixed Methods Study.JMIR medical informatics · 2025Article
- Guideline concordance of electronic health record order sets for hospital-based treatment of alcohol withdrawal syndrome.Journal of hospital medicine · 2025Article
- Nurses' Perception towards Electronic Medical Records System: An Integrative Review of Barriers and Facilitators.Iranian journal of public health · 2025Review
- Patterns and Perceptions of Standard Order Set Use Among Physicians Working Within a Multihospital System: Mixed Methods Study.JMIR formative research · 2024Article
- The Environmental Impacts of Electronic Medical Records Versus Paper Records at a Large Eye Hospital in India: Life Cycle Assessment Study.Journal of medical Internet research · 2024Article
- Assessing the efficient use of the lightwave health information management system for health service delivery in Ghana.BMJ health & care informatics · 2023Article
- Show me the money: how do we justify spending health care dollars on digital health?The Medical journal of Australia · 2023Article
- Research and Application of Artificial Intelligence Based on Electronic Health Records of Patients With Cancer: Systematic Review.JMIR medical informatics · 2022Review
- Improving Evidenced-based Outpatient Order Set Utilization in the Gastrointestinal Division of a Large Pediatric Health System.Pediatric quality & safetyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care.
objectiveA systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes.
methodsArticles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care.
resultsMost of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare.
conclusionsThe literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.
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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.