OBJECTIVES: Quality of care for cancer may improve with information technology products such as ELECTRONIC MEDICAL RECORDS (EMR). The objectives of this study were 1) to identify aspects of value of EMR use to providers in assessing and improving quality cancer care and 2) to identify issues in cost-effectiveness of EMR from the provider perspective.
METHODS: A systematic literature review regarding perceptions of the quality of cancer care in the United States was conducted in PubMed, EMBASE, and Cochrane Reviews for the last 10 years, English only articles. Oncology medical subject heading (MESH) terms were cross-matched with quality of care MESH terms to obtain 875 abstracts. Of these, 140 publications were selected for full-article review based on defined inclusion/exclusion criteria.
RESULTS: Reports of EMR use among hospitals, hospital networks (for example, Veterans Hospital Administration), and moderately sized oncology practices indicated that providers rapidly obtained information on guideline adherence and determined whether patients received follow-up in physician offices. Cost savings were incurred across multidisciplinary teams because fewer tests were duplicated. Business management costs for billing were reduced. Other cost savings were lower labor costs due to reduced need for medical records staff, and staff to provide information among caregivers and to direct patient flow. Cost effectiveness was variable for small physician practices, with some providers recovering the cost of the EMR system and others incurring serious financial problems as a result of implementing EMR use in their practices.
CONCLUSIONS: EMR may be financially challenging for some small physician practices. However, it can assist providers in assessing whether their patients are receiving guideline-adherent care and aid in more efficient processes of care, thereby improving overall quality of cancer care.
