international journal of medical informatics 83 ( 2 0 1 4 ) 37–46 journal homepage: www.ijmijournal.com Which functionalities are available in the electronic health record systems used by French general practitioners? An assessment study of 15 systems David Darmon a,* , Rémy Sauvant a , Pascal Staccini b , Laurent Letrilliart c a Département d’Enseignement et de Recherche en Médecine Générale, Faculté de Médecine, Université de Nice Sophia-Antipolis, France b LabSTIC, Faculté de Médecine, Université de Nice Sophia Antipolis, France c Département de Médecine Générale, Faculté de Médecine Lyon-Est, Université de Lyon 1, France article info Article history: Received 6 July 2012 Received in revised form 10 October 2013 Accepted 11 October 2013 Keywords: Electronic health record Evaluation study as a topic General practice abstract Objective: Whereas an unprecedented effort is currently under way worldwide for the implementation of electronic health record (EHR) systems, their capabilities are poorly understood, especially in primary care. The objective of this study was to assess the main functionalities of the EHR systems used in French general practices. Methods: Among the 20 EHR systems marketed in France, we assessed the 15 systems used by more than 1500 general practitioners in the Provence-Alpes-Côte d’Azur region in the southeast part of France. Each EHR system was assessed in a general practice office, using two clinical vignettes describing virtual patient consultations. The evaluation crite- ria were derived from the EuroRec requirements for EHR system quality. The assessment scale included 37 criteria grouped into three sets: background data, consultation data, and exchange functionalities. The scoring system used, totalling 64 points, was based on the validation of the criteria and was adjusted based on the possibility of standardising the data. A high score indicated a good EHR system quality. Results: The median global score was 32 points out of a possible 64 (range: 20–39). The median score was 12 points out of 22 (range: 6–15) for the background data set, 16 points out of 32 (range: 9–22) for the consultation data set, and four points out of 10 (range: 0–6) for the exchange functionalities. No association was found between the number of users and the assessment score of the EHR systems (p = 0.79). One third of the EHR systems lacked a problem list and only one of them supported the episode of care. Conclusion: Functionalities noticeably vary among the EHR systems currently used in French primary care. Whereas these systems are globally very focused on drug prescriptions, several core functionalities are frequently lacking. They are also poorly interoperable for healthcare professionals and patients. Further research is necessary to assess their actual use. © 2013 Elsevier Ireland Ltd. All rights reserved. ∗ Corresponding author. Tel.: +33 660598642. E-mail address: david.darmon@unice.fr (D. Darmon). 1. Introduction Electronic health record (EHR) systems are part of an evolving concept comprising a wide range of information systems, from files compiled in single units of care to longitudinal collections of patient electronic health data [1]. EHR systems’ primary use is to support the continuation of efficient and quality 1386-5056/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijmedinf.2013.10.004