Evaluation of Electronic Medical Record Administrative data Linked Database (EMRALD).

BACKGROUND

Primary care electronic medical records (EMRs) represent a potentially rich source of information for research and evaluation.

OBJECTIVE

To assess the completeness of primary care EMR data compared with administrative data.

STUDY DESIGN

Retrospective comparison of provincial health-related administrative databases and patient records for more than 50,000 patients of 54 physicians in 15 geographically distinct clinics in Ontario, Canada, contained in the Electronic Medical Record Administrative data Linked Database (EMRALD).

METHODS

Physician billings, laboratory tests, medications, specialist consultation letters, and hospital discharges captured in EMRALD were compared with health-related administrative data in a universal access healthcare system.

RESULTS

The mean (standard deviation [SD]) percentage of clinic primary care outpatient visits captured in EMRALD compared with administrative data was 94.4% (4.88%). Consultation letters from specialists for first consultations and for hospital discharges were captured at a mean (SD) rate of 72.7% (7.98%) and 58.5% (15.24%), respectively, within 30 days of the occurrence. The mean (SD) capture within EMRALD of the most common laboratory tests billed and the most common drugs dispensed was 67.3% (21.46%) and 68.2% (8.32%), respectively, for all clinics.

CONCLUSIONS

We found reasonable capture of information within the EMR compared with administrative data, with the advantage in the EMR of having actual laboratory results, prescriptions for patients of all ages, and detailed clinical information. However, the combination of complete EMR records and administrative data is needed to provide a full comprehensive picture of patient health histories and processes, and outcomes of care.