It remains largely unknown how use of electronic health records (EHR) impacts ordering of preventive/screening services (PSS). These analyses examined the influence of confirmed Medicaid provider EHR adoption on primary care ordering rates of five major PSS. Sample was comprised of 10,149 continuously enrolled Michigan Medicaid adults linked to 6,587 providers.


The authors obtained complete office-based billing claims data from the Michigan Medicaid Data Warehouse for adults with 29 or more months of continuous state Medicaid coverage. PSS claims data were linked to patients’ Medicaid-assigned providers who either had, or had not, EHR-attested during the 60-month analytic window.


Final predictive models with consistent EHR provider-patient dyads demonstrated both significant increases and decreases in order rates for office-based PSS compared to non-EHR dyads. Similar to the authors’ earlier work, the authors conclude that while EHR modules prompted many providers to increase some PSS ordering, their improved access to historical documentation also decreased redundant or premature orders.


Based on these results, future controlled studies examining the apparent mixed influences derived from increased use of different EHR technologies on PSS ordering rates are certainly required.