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Medical Care Research and Review
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Reviews

Review: Use of Electronic Medical Records for Health Outcomes Research

A Literature Review

Bonnie B. Dean

Cerner LifeSciences, Beverly Hills, CA, bdean{at}cerner.com

Jessica Lam

Cerner LifeSciences, Beverly Hills, CA

Jaime L. Natoli

Cerner LifeSciences, Beverly Hills, CA

Qiana Butler

Cerner LifeSciences, Beverly Hills, CA

Daniel Aguilar

Cerner LifeSciences, Beverly Hills, CA

Robert J. Nordyke

Amgen, Inc., Thousand Oaks, CA

This review assessed the use of electronic medical record (EMR) systems in outcomes research. We systematically searched PubMed to identify articles published from January 2000 to January 2007 involving EMR use for outpatient-based outcomes research in the United States. EMR-based outcomes research studies (n = 126) have increased sixfold since 2000. Although chronic conditions were most common, EMRs were also used to study less common diseases, highlighting the EMRs’ flexibility to examine large cohorts as well as identify patients with rare diseases. Traditional multi-variate modeling techniques were the most commonly used technique to address confounding and potential selection bias. Data validation was a component in a quarter of studies, and many evaluated the EMR’s ability to achieve similar results previously achieved using other data sources. Investigators using EMR data should aim for consistent terminology, focus on adequately describing their methods, and consider appropriate statistical methods to control for confounding and treatment-selection bias.

Key Words: electronic medical records • electronic health care records • computerized medical records • outcomes research

This version was published on December 1, 2009

Medical Care Research and Review, Vol. 66, No. 6, 611-638 (2009)
DOI: 10.1177/1077558709332440
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