The impact of an integrated hospital-community medical information system on quality of care and medical service utilisation in primary-care clinics

Background. In 2005, an innovative system of hospital-community, on-line medical records (OFEK) was introduced in Clalit Health Services (CHS). Goals. aEuro integral To examine OFEK's use and impact on quality indicators and medical-service utilisation in CHS primary-care clinics. Methods. aEuro integral Examining the frequency of OFEK's use with its own track-log data; comparing ''before'' and ''after'' quality indicators and service utilisation of experimental versus control clinics. Results. aEuro integral Use of OFEK increased by hundreds of percent between 2005 and 2006, continued rising at a slower rate in 2007 and decreased slightly in 2008. At clinics in catchment areas of hospitals using OFEK extensively, OFEK reduced the number of imaging tests and, to a lesser extent, laboratory testing and improved several quality measures. An examination of all clinics in the catchment areas and in the study revealed a much weaker impact. Conclusions. aEuro integral OFEK's introduction affected a number of outcome measures -- some, significantly -- in medical and financial terms. Its increased use at additional clinics may exert a stronger impact there, too. The study contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems.