Feedback and training tool to improve provision of preventive care by physicians using EMRs: a randomised control trial

Heather Maddocks, Moira Stewart, Amardeep Thind, Amanda Terry, Vijaya Chevendra, Neil Marshall, Louisa Denomme, Sonny Cejic


Background Electronic medical records (EMRs) have the potential to improve the provision of preventive care by allowing general practitioners (GPs) to track and recall eligible patients and record testing for feedback on their service provision.
Objective This study evaluates the effect of an educational intervention and feedback tool designed to teach GPs how to use their EMRs to improve their provision of preventive care.
Methods A randomised controlled trial comparing rates of mammography, Papanicolaou tests, faecal occult blood tests and albumin creatinine ratios one-year pre- and post-intervention was conducted. Nine primary care practices (PCPs) representing over 30 000 patients were paired by practice size and experience of GPs, and randomly allocated to intervention or control groups. Physicians at the four intervention practices received a two-hour feedback session on their current level of preventive care and training to generate eligible patient lists for preventive services from their EMR database.
Results One-year post-intervention results provided no evidence of a difference. The intervention was not a significant predictor of the one-year post-intervention test rates for any of the four tests. On average, the intervention practices increased postintervention test rates on all tests by 16.8%, and control practices increased by 22.3%.
Conclusion The non-significant results may be due to a variety of reasons, including the level of intensity of the educational intervention, the cointervention of a government programme which provided incentives to GPs meeting specific targets for preventive care testing or the level of recording of tests performed in the EMR.


albumin creatinine ratio; electronic medical record; faecal occult blood test; intervention; mammography; Papanicolaou Test; primary health care; randomised controlled trial; vaginal smear

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