Table 3.
Adjusted zero-inflated negative binomial models examining the main effect of electronic health record systems on the number of patients with rheumatoid arthritis who received recommended care.
| Electronic health record system | Disease activity measure performance | Functional status measure performance | ||||||||
|
|
Incidence rate ratioa, ratio (95% CI) | P value | Incidence rate ratio, ratio (95% CI) | P value | ||||||
| Count Model | ||||||||||
|
|
NextGen | Reference | Reference | Reference | Reference | |||||
|
|
eClinicalWorks | 0.84 (0.59-1.18) | .31 | 0.84 (0.55-1.31) | .45 | |||||
|
|
GE Centricity | 0.88 (0.61-1.27) | .50 | 1.10 (0.66-1.82) | .71 | |||||
|
|
eMDs | 0.81 (0.44-1.48) | .49 | 0.67 (0.20-2.27) | .52 | |||||
|
|
Allscripts | 0.37 (0.07-1.98) | .25 | 1.08 (0.72-1.63) | .72 | |||||
|
|
Amazing Charts | 1.23 (0.78-1.92) | .37 | 1.34 (0.80-2.25) | .27 | |||||
|
|
Aprima | 1.16 (0.79-1.71) | .46 | 1.27 (0.78-2.07) | .35 | |||||
|
|
Othersb | 0.81 (0.50-1.32) | .40 | 1.15 (0.78-1.69) | .49 | |||||
| Zero Inflated Model | ||||||||||
|
|
NextGen | Reference | Reference | Reference | Reference | |||||
|
|
eClinicalWorks | 0.21 (–1.27 to 1.69) | .78 | 1.80 (0.72 to 2.89) | <.001 c | |||||
|
|
GE Centricity | –19.01 (–20.08 to –17.94) | <.001 | 1.47 (–0.11 to 3.05) | .07 | |||||
|
|
eMDs | 1.92 (0.41 to 3.43) | .01 | 2.87 (1.40 to 4.34) | <.001 | |||||
|
|
Allscripts | 2.48 (0.85 to 4.11) | .003 | 2.82 (1.17 to 4.48) | <.001 | |||||
|
|
Amazing Charts | 1.02 (–0.38 to 2.42) | .16 | 2.21 (1.03 to 3.40) | <.001 | |||||
|
|
Aprima | 1.97 (0.28 to 3.65) | .02 | 2.31 (0.70 to 3.93) | .01 | |||||
|
|
Otherb | 3.17 (2.13 to 4.21) | <.001 | 3.37 (2.36 to 4.39) | <.001 | |||||
aIn the count model, the incidence rate ratios represent the rate of having patients who received recommended care compared to NextGen; in the zero inflated model, the incidence rate ratios represent the rate of having zero performance compared to NextGen. Incidence rate ratios were adjusted for practice characteristics and patient case-mix.
bOther electronic health record systems included any system used in <2% of practices, including Lytec MD, Medent, Medisoft, Raintree System IC, MD office, Integrity, Carecloud, MedTrio, Greenway/Primesuite, iPatientCare, Prime Clinical System, MacPractice MD, IMS, SRS EHR, PrognoCIS, Cerner, Practice Fusion, DrChrono, Chart Maker Clinical, STI, American Medical Software, Athena Clinicals, Praxis EMR, RheumDocs, Greenway Intergy, Athena UniCharts, and ChartLogic.
cItalicized P values are statistically significant.