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A Proposal for Electronic Medical Records in U.S. Primary Care

Affiliations of the authors: Center for Applied Medical Informa-tion Systems, Partners Healthcare System; Division of General Medicine and Primary Care, Brigham and Women’s Hospital; and Harvard Medical School, Boston, Massachusetts (DWB); Department of Family Practice, Michigan State University, East Lansing, Michigan (ME); Pediatric Center, Stone Mountain, Georgia (EG); Mercy Medical Center, Redding, California (JZ); Department of Family Practice, University of South Alabama, Mobile, Alabama (HCM).

Correspondence and reprints: David W. Bates, MD, MSc, Division of General Medicine and Primary Care, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115; e-mail: <dbates{at}partners.org>.

Received for publication: 02/11/02; accepted for publication: 09/10/02.

Delivery of excellent primary care—central to overall medical care—demands that providers have the necessary information when they give care. This paper, developed by the National Alliance for Primary Care Informatics, a collaborative group sponsored by a number of primary care societies, argues that providers’ and patients’ information and decision support needs can be satisfied only if primary care providers use electronic medical records (EMRs). Although robust EMRs are now available, only about 5% of U.S. primary care providers use them. Recently, with only modest investments, Australia, New Zealand, and England have achieved major breakthroughs in implementing EMRs in primary care. Substantial benefits realizable through routine use of electronic medical records include improved quality, safety, and efficiency, along with increased ability to conduct education and research. Nevertheless, barriers to adoption exist and must be overcome. Implementing specific policies can accelerate utilization of EMRs in the U.S.