BOSTON – A new Rand study is one of the first to link the use of electronic health records in community-based medical practices with higher quality of care.

Rand Corporation researchers found in a study of 305 groups of primary care physicians that the routine use of multifunctional EHRs was more likely to be linked to higher quality care than other common strategies, such as structural changes used for improving care.

Researchers examined 13 structural capabilities – such as giving physicians feedback on their performance, sending reminders to physicians and patients about needed services, having language interpreter services, offering appointments on evenings and weekends and adopting electronic health records – through information about physician practices collected by Massachusetts Health Quality Partners.

Assessing those measures, researchers found that primary care medical practices improved quality in four clinical areas – diabetes treatment, depression care, overuse of medical technology and common health screenings. Practices that used multifunctional EHRs performed better on five of the quality measures – two involving diabetes care and screenings for breast cancer, colorectal cancer and chlamydia.

Medical practice groups that had frequent meetings to discuss quality reported better results for three measures of diabetes care. Practices that reported high physician awareness of patient experience ratings reported higher performance on screenings for breast and cervical cancer. No other structural capabilities were associated with more than one measure of quality, and no capabilities were associated with better performance on depression care or overuse of services.

EHRs were linked to higher quality care when the systems included advanced functions such as electronic reminders to physicians, and if the systems were used routinely by a medical practice.

"Overall, we were surprised by how few strategies to improve the quality of care were linked to measurably better performance," said Mark W. Friedberg, the study's lead author and an associate natural scientist at Rand, a nonprofit research organization. "The strategy that showed the most impact was use of advanced electronic health records."

Researchers say their findings are relevant to ongoing discussions about the potential benefits of broadly adopting EHRs across the nation's healthcare system.

"Electronic health records with advanced features are uncommon nationally," Friedberg said. "Our results suggest that increasing their adoption may help improve the quality of care in important areas of preventive care and chronic disease management."