Building a results review system: a critical first step in transitioning from paper medical records.

Electronic health records (EHRs) are valuable tools for efficiently delivering safe and effective care, yet the majority of providers continue to rely on paper based systems. Cost is a significant barrier to adoption. Providers unable to afford a comprehensive EHR may still be capable of taking a less costly first step toward improving quality and safety with less aggressive yet effective clinical information system strategies. We identified a single, clearly definable, clinical information need: Improving the delivery of results and reports. We built a results review system to improve the efficiency and reliability of access to clinical information for providers working in the New Orleans safety net for the under/uninsured. We measured provider satisfaction with clinical information delivery systems before and after implementation and analyzed the rate of adoption and ongoing system utilization. Providers expressed increased satisfaction, and showed rapid adoption and an ongoing high rate of utilization over time.