Do electronic medical records improve diabetes quality in physician practices?

Objectives: To measure the effect of electronic medical records (EMRs) on a publicly reported composite measure indicating optimal diabetes care (ODC) rates in ambulatory settings. Study Design: Data from Minnesota Community Measurement on 557 clinics were used, including information on ODC, EMR adoption, and clinic characteristics. Methods: A difference-in-differences strategy was used to estimate the impact of EMR adoption on patient outcomes while controlling for observed and unobserved clinic characteristics. Results were compared with a cross-sectional analysis of the same data. Results: EMRs had no observable effect on ODC for the average clinic during the first 2 years postadoption. EMRs may, however, generate modest (+4 percentage point) ODC increases for clinics in large, multisite practices. Cross-sectional analysis likely overestimates the effect of EMRs on quality. Conclusions: There is little evidence that EMR adoption improves diabetes care during the first 2 years postadoption. This is notable as diabetes is a condition for which information technology has the potential to improve care management. The results suggest that policy makers should not expect public sector EMR investments to yield significant short-term improvements in publicly reported measures.