Do Electronic Health Records Improve Care in Small Practices?

    • June 3, 2015

Researchers at Weill Cornell Medical College evaluated the impact of electronic health records and technical assistance on outpatient care at small practices caring for underserved patients in New York City.

Dates of Project: November 2010 through July 2012


In 2005, the New York City Department of Health and Mental Hygiene created the Primary Care Information Project to subsidize the adoption of electronic health records by small primary care practices serving low-income and minority neighborhoods, and to help physicians learn to use the records. In this study, Cornell researchers examined whether the quality of care improved among physicians in the project more than among physicians who did not participate, and the role of technical assistance in that outcome.

Key Findings

  • Physicians participating in the Primary Care Information Project did not see more overall improvement on 10 HEDIS measures of health care quality than physicians in the comparison group saw.

  • However, for five measures that are sensitive to the use of electronic health records, their use correlated with significantly higher quality of care—but only among participating physicians who had used such records for at least nine months and received high levels of technical assistance.

  • These findings suggest that federally funded regional extension centers can play an important role in facilitating the use of electronic health records to improve the quality of care.

All 17 physicians interviewed by the researchers felt that quality of care improved because of electronic health records and that technical assistance was useful. One Bronx pediatrician told the interviewer he “would quit if they took the electronic health records from me.”

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To ensure that electronic health records improve care, researchers found TA for physicians is critical.