Are printed medical records better than electronic medical records?

Are printed medical records better than electronic medical records? (John Moore, Getty Images / May 30, 2012)

It's not clear why the gap existed, according to Crosson.

He said they had no information on the specific features of the electronic systems offices were using. So it's not possible to say whether certain systems or software features are more effective than others.

But Crosson also pointed to the human element: doctors and their staffs need to shift their mindsets, as well as their records systems. "There needs to be a change in the way doctors think about the delivery of care," Crosson said.

That might include having someone on staff who calls patients with chronic conditions, like diabetes, to "check in to see how they are doing," he said.

The study does have limitations, Crosson's team points out. One is that the data were collected between 2004 and 2006 — and the systems used right now in many doctors' offices may be different.

Electronic records are not the only quality-improvement measure that researchers and policymakers are considering. Information from patients' e-records can also be used in so-called "pay-for-performance" plans.

Those plans offer financial incentives to doctors who achieve certain goals that are known to improve patients' health, reduce errors or save money.

Some governments, in Canada and the UK, for example, have tested pay-for-performance plans — as have some doctor-hospital networks in the U.S.

But a study published last month found that an Ontario program seemed to have made no impact on diabetes patients' quality of care.

Another new study, also in the Annals of Family Medicine, points to similar results in the UK. Looking at 29 family practices in London, researchers found that pay-for-performance incentives have had little impact on long-standing racial disparities in diabetes care.

According to the researchers, that all suggests broad policy shifts are, by themselves, insufficient. More "targeted" steps also seem necessary, they say.

For now, Crosson said, people with diabetes — or other chronic conditions — should not assume they are getting top-notch care simply because their doctor's office has gone digital.

"Even if they are using electronic records, things may still be falling through the cracks," Crosson said.

He suggested that people find out what types of tests and treatments are guideline-recommended for their particular health problem. If you have diabetes, one source would be the American Diabetes Association, he said.

Another good source, Crosson noted, is the U.S. Preventive Services Task Force — an expert panel that makes testing recommendations on a variety of health conditions.

SOURCE: and Annals of Family Medicine, May/June 2012.