TY - JOUR T1 - The adoption of an electronic health record did not improve A1c values in Type 2 diabetes JF - BMJ Health & Care Informatics SP - 433 LP - 438 DO - 10.14236/jhi.v23i1.144 VL - 23 IS - 1 AU - Harry B. Burke AU - Dorothy A. Becher AU - Albert Hoang AU - Ronald W. Gimbel Y1 - 2016/01/01 UR - http://informatics.bmj.com/content/23/1/433.abstract N2 - Background A major justification for the clinical adoption of electronic health records (EHRs) was the expectation that it would improve the quality of medical care. No longitudinal study has tested this assumption.Objective We used hemoglobin A1c, a recognized clinical quality measure directly related to diabetes outcomes, to assess the effect of EHR use on clinical quality.Methods We performed a five-and-one-half-year multicentre longitudinal retrospective study of the A1c values of 537 type 2 diabetic patients. The same patients had to have been seen on at least three occasions: once approximately six months prior to EHR adoption (before-EHR), once approximately six months after EHR adoption (after-EHR) and once approximately five years after EHR adoption (five-years), for a total of 1,611 notes.Results The overall mean confidence interval (CI) A1c values for the before-EHR, after-EHR and five-years were 7.07 (6.91 – 7.23), 7.33 (7.14 – 7.52) and 7.19 (7.06 – 7.32), respectively. There was a small but significant increase in A1c values between before-EHR and after-EHR, p = .04; there were no other significant differences. There was a significant decrease in notes missing at least one A1c value, from 42% before-EHR to 16% five-years (p < .001).Conclusion We found that based on patient’s A1c values, EHRs did not improve the clinical quality of diabetic care in six months and five years after EHR adoption. To our knowledge, this is the first longitudinal study to directly assess the relationship between the use of an EHR and clinical quality. ER -