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A Spark to Revitalize Primary Care?

Thomas Bodenheimer, MD; Kevin Grumbach, MD

JAMA. 2003;290:259-264.

The computer revolution has enormous potential to improve primary care in the areas of medical records, communication between physicians and patients, information sharing among health care providers, and rapid access to reliable medical information for both physicians and patients. A number of barriers must be overcome before computerization is widely embraced in primary care: e-health often takes too much time and is too expensive; the quality of Web-based medical information is inadequate; software programs may not interact with one another; patient privacy must be protected; public and private insurers rarely pay for electronic communication with patients; and the computer could interfere with the patient-physician relationship. Studies have shown that some computerized systems, such as reminder prompts and physician performance feedback, may improve physician performance and patient outcomes, but if these systems are too time-consuming, physicians may not use them. If primary care practices are to benefit from the electronic revolution, they must redesign their clinical processes to ensure that e-health facilitates rather than hinders the work of physicians.

Author Affiliations: Department of Family and Community Medicine, University of California, San Francisco.

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