Increasing Timely and Available Prenatal Studies by Electronic Health Records

Background: The government is encouraging the adoption of electronic medical records (EMRs). There is little information about using EMRs in the obstetric literature and none about using them in family medicine residencies. Our purpose was to assess if using an EMR was associated with improvement in the ordering and availability of prenatal tests. Methods: A retrospective chart review comparing the rate at which prenatal laboratory values were present on the chart, ordered on time, and recorded on a prenatal flow sheet. Results: Comparison of charts before and after implementation of an EMR showed statistically significant improvement in the percent of patients with all first trimester (87.5% vs 96.0%; P = .0025), quadruple screening tests (91.1% vs 98.1%; P = .012), and second trimester screening results (93.5% vs 100%; P = .044) in their charts; first trimester laboratory tests (91.6% vs 99.5%; P = .001) and second trimester ultrasounds (90.9% vs 97.3%; P = .027) being ordered on time; and first trimester results (88.2% vs 95.5%; P = .009), quad screen results (93.1% vs 98.0%; P = .0495), and second trimester ultrasounds (93.5% vs 100%; P = .003) being recorded on the American Congress of Obstetricians and Gynecologists flow sheet. Conclusion: Adopting an EMR was associated with an improved rate at which prenatal tests were ordered on time, present on the chart, and recorded on a prenatal flow sheet. (J Am Board Fam Med 2011;24:344-350.)