Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Jul 3, 2025
Open Peer Review Period: Jul 21, 2025 - Sep 15, 2025
Date Accepted: Dec 17, 2025
(closed for review but you can still tweet)
Development of quality indicators for the correct use of electronic medical records in primary care using a Delphi-derived method
ABSTRACT
Background:
When used correctly, electronic medical records (EMRs) can support clinical decision-making, provide information for research, facilitate coordination of care, reduce medical errors, and generate patient health summaries. Studies have reported large differences in the quality of EMR data.
Objective:
Our study aimed to develop an evidence-based set of electronically extractable quality indicators (QIs) approved by expert consensus to assess the good use of EMRs by general practitioners (GPs) from a medical perspective.
Methods:
The RAND-modified Delphi method was used in this study. The TRIP and MEDLINE databases were searched, and a selection of recommendations was filtered using the SMART principle. The panel comprised 12 GPs and 6 EMR developers. The selected recommendations were transformed into QIs as percentages.
Results:
A combined list of 20 indicators and 30 recommendations was created from nine guidelines and four review articles. After the consensus round, 20 indicators and 20 recommendations were approved by the panel. All 20 recommendations were transformed into QIs. Most QIs evaluate the completeness and adequacy of the problem list.
Conclusions:
This study provided a set of 40 EMR-extractable QIs for the correct use of EMRs in primary care. These QIs can be used to map the completeness of EMRs by setting up an audit and feedback system and to develop specific (computer-based) training for GPs.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.