As for why diabetes and screening topped the list, but not depression management, it could be because the companies that design EHR software "might be prioritizing reminder functions that target screening and diabetes measures," Dr. Friedberg notes. The reason? EHR makers are catering to their audience: Routine testing for STDs and cancer, as well as diabetes procedures like eye exams, are favorite targets of "pay-for-performance" and public performance reporting, according to Dr. Friedberg, so doctors might want to be reminded to do them.

EHRs need to have advanced features

"A primary care clinic should not expect an EHR to be a 'quality panacea,'" Dr. Friedberg cautions. "It seems unlikely that adopting an advanced EHR would take a practice from, say, 60% to 90% performance on any of the measures we investigated. Other efforts to improve performance would also probably be needed."

But if clinics trade their paper for silicon and are looking for a boost in performance, they should search for systems with advanced features, Dr. Friedberg argues, which incorporate laboratory and radiology results, medication and event lists, and medical record notes. In his study, clinics using more basic EHRs, with only lab and radiology results, saw smaller performance gains across fewer quality measures.

The Annals of Internal Medicine paper ran October 6. This report originally appeared in DOTmed News October 9.


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