In our recently published study,1 using nationally representative outpatient visit data, we found no association between clinical decision support-enabled EHR use and quality of care. We acknowledge several of the limitations that Mohan and Hersh point out. Specifically, we agree that having more complete and recent information on clinical practices, patient outcomes, and EHRs would be valuable. Unfortunately, national-level data fully addressing these concerns are not available. We continue to believe that our analysis of a quarter-million patient visits contributes to understanding the relationship between EHRs and ambulatory care quality.
Romano M, Stafford R. Electronic Health Records, the PINNACLE Registry, and Quality Care—Reply. Arch Intern Med. 2011;171(10):941-954. doi:10.1001/archinternmed.2011.190