Depression may go overlooked when physicians use electronic medical records, researchers find

August 16, 2012

(Medical Xpress) -- Patients who have three or more chronic medical conditions are half as likely to receive depression treatment in primary care practices that use electronic medical records as they are in practices that use paper-based records, a new University of Florida study has found.

, or EMRs, are generally thought to improve health care by allowing better of care and increased in and treatment. But the UF study raises questions about how computerized records systems could affect .

The findings appear in the August issue of the .

“While we don’t know why EMRs are associated with lower odds of depression treatment in with multiple conditions, we think that either they reduce the amount of interaction between patients and physicians or they focus a physician’s attention on physical health issues, pushing mental health issues off the radar screen,” said lead investigator Jeffrey Harman, an associate professor and the Louis C. and Jane Gapenski Term Professor of Health Services Administration at the UF College of Public Health and Health Professions.

Under the 2009 Health Information Technology for Economic and Clinical Health Act, the federal government offers incentive payments for Medicare and Medicaid providers who adopt electronic health record systems. Practitioners and hospitals must demonstrate “meaningful use” of the electronic health systems, that is, improvements in quality, safety and effectiveness of care. In 2011, 57 percent of office-based physicians were using EMRs, according to the National Center for Health Statistics.

The UF study team, which included Dr. Robert Cook, a UF associate professor of epidemiology and medicine, Christopher Harle, a UF assistant professor of health services research, management and policy, and Kathryn Rost, a University of South Florida research professor of mental health law and policy, analyzed 2006-2008 data from the National Ambulatory Medical Care Survey, a nationally representative sample of physician-office visits. They looked at all visits in which patients 18 and older received a depression diagnosis, a total of 3,467 visits, and noted whether the physician prescribed or continued antidepressant medication, mental health counseling or a combination.

in patients with one or two chronic conditions did not differ between EMR and non-EMR practices. But if patients had three or more conditions, they were half as likely to receive depression care at an EMR practice.

In previous studies of EMRs in inpatient settings, physicians reported that entering data is more time-consuming, as it requires clicking through many screens and system options. The result could be decreased psychosocial interactions between doctors and patients, Harman said.

“There is some evidence that typing these notes into the computer is actually reducing the amount of time that physicians and patients talk to each other during visits,” Harman said. “If the physician only has time to address two out of three conditions, depression may be the one that they’re not talking about.”

The researchers also theorize that the prompts and guidelines in EMRs are focused more on biomedical issues than . Still, more research is needed to prove whether EMR use is responsible for the levels of depression care noted.

“Although the UF study is unable to determine a causal relationship between EMR adoption and decreased quality of depression care, identifying such an association is an important first step in better understanding the impact of EMRs on our health care system,” said Nir Menachemi, a professor of health care organization and policy at the University of Alabama at Birmingham School of Public Health, who was not involved in the UF research. “The next step will be to rule out that physicians who adopt EMRs are not somehow different from those who do not, which may explain the differences observed. Either way, I commend the team at UF for contributing valuable information to the ongoing debate on this critical topic.”

Explore further: Lifestyle counseling and glycemic control in patients with diabetes: True to form?

Related Stories

Lifestyle counseling and glycemic control in patients with diabetes: True to form?

May 24, 2011
Electronic medical records (EMRs) have been in use for more than 30 years, but have only increased in utilization in recent years, due in part to research supporting the benefits of EMRs and federal legislation. As EMRs have ...

Health IT expert says electronic medical records finally catching on

June 19, 2012
The U.S. Olympic Committee is converting to electronic medical records (EMRs) this month for hundreds of athletes who will be competing in London, as well as thousands of other athletes who have been seen by Olympic Committee ...

Use of patient centered medical home features not related to patients' experience of care

June 8, 2012
Providing patient care using key features of a Patient-Centered Medical Home (PCMH), a model of health care delivery promoted by major physician groups, may not influence what patients think about the care they receive, reports ...

Recommended for you

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.