primary care
Flanagan ME et al, J Am Med Inform Assoc, 2013
BACKGROUND:
Healthcare professionals develop workarounds rather than using electronic health record (EHR) systems. Understanding the reasons for workarounds is important to facilitate user-centered design and alignment between work context and available health information technology tools.
OBJECTIVE:
To examine both paper- and computer-based workarounds to the use of EHR systems in three benchmark institutions.
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Published:
14 March 2013 |
Keyword(s): Electronic Health Records, Primary Care, United States
Xierali IM et al, The Annals of Family Medicine, 11(1)
PURPOSE
Realizing the benefits of adopting electronic health records (EHRs) in large measure depends heavily on clinicians and providers’ uptake and meaningful use of the technology. This study examines EHR adoption among family physicians using 2 different data sources, compares family physicians with other office-based medical specialists, assesses variation in EHR adoption among family physicians across states, and shows the possibility for data sharing among various medical boards and federal agencies in monitoring and guiding EHR adoption.
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Published:
2 January 2013 |
Keyword(s): Adoption, Electronic Health Records, General practitioners, Primary Care, United States
Delbanco T et al, Annals of internal medicine, 157(7)
BACKGROUND
Little information exists about what primary care physicians (PCPs) and patients experience if patients are invited to read their doctors’ office notes.
OBJECTIVE
To evaluate the effect on doctors and patients of facilitating patient access to visit notes over secure Internet
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Published:
2 October 2012 |
Keyword(s): Communication, Confidentiality, Electronic Health Records, General practitioners, Internet, Patient Record Access, Physician-Patient Relationship, Primary Care, United States
Green LV et al, Health Affairs, 32(1)
Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients’ ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns.
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Published:
January 2013 |
Keyword(s): Access, Electronic Health Records, Physicians, Primary Care, United States
Ryan AM et al, Health Affairs, 32(1)
The 2009 American Recovery and Reinvestment Act spurred adoption of electronic health records (EHRs) in the United States, through such measures as financial incentives to providers through Medicare and Medicaid and regional extension centers, which provide ongoing technical assistance to practices. Yet the relationship between EHR adoption and quality of care remains poorly understood. We evaluated the early effects on quality of the Primary Care Information Project, which provides subsidized EHRs and technical assistance to primary care practices in underserved neighborhoods in New York City, using the regional extension center model.
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Published:
1 January 2013 |
Keyword(s): Adoption, Electronic Health Records, Information Technology, Primary Care, Quality, United States
McGowan BS et al, Journal of medical Internet research, 2012
BACKGROUND
Within the medical community there is persistent debate as to whether the information available through social media is trustworthy and valid, and whether physicians are ready to adopt these technologies and ultimately embrace them as a format for professional development and lifelong learning.
OBJECTIVE
To identify how physicians are using social media to share and exchange medical information with other physicians, and to identify the factors that influence physicians’ use of social media as a component of their lifelong learning and continuing professional development.
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Published:
24 September 2012 |
Keyword(s): Oncology, Physicians, Primary Care, Social Media, United States
Singh H et al, J Am Med Inform Assoc, 2012
CONTEXT:
Failure to notify patients of test results is common even when electronic health records (EHRs) are used to report results to practitioners. We sought to understand the broad range of social and technical factors that affect test result management in an integrated EHR-based health system.
METHODS:
Between June and November 2010, we conducted a cross-sectional, web-based survey of all primary care practitioners (PCPs) within the Department of Veterans Affairs nationwide. Survey development was guided by a socio-technical model describing multiple inter-related dimensions of EHR use.
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Published:
25 December 2012 |
Keyword(s): Electronic Health Records, Primary Care, Test results, United States, Veterans Affairs
Bowen M, Lau F. ElectronicHealthcare, 11(1)
Data collected by primary care providers in electronic medical record (EMR) systems can be used to support a variety of actions including provision of day-to-day care, decision support, practice reflection, research and public health surveillance. The extent to which EMR data can be relied on to support such actions is dependent on the quality of the held data. While a body of literature describing data quality assessment techniques exists, few studies speak to the challenges of evaluating data quality in the Canadian primary care setting. In response, researchers at the University of Victoria’s eHealth Observatory are refining data quality definitions and developing techniques for the evaluation of EMR data quality within the Canadian primary care context.
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Published:
25 June 2012 |
Keyword(s): Canada, Electronic Health Records, Electronic Medical Records, Evaluation, Primary Care, Quality
Parsons A et al, J Am Med Inform Assoc, 2012
Background
Since 2007, New York City’s primary care information project has assisted over 3000 providers to adopt and use a prevention-oriented electronic health record (EHR). Participating practices were taught to re-adjust their workflows to use the EHR built-in population health monitoring tools, including automated quality measures, patient registries and a clinical decision support system. Practices received a comprehensive suite of technical assistance, which included quality improvement, EHR customization and configuration, privacy and security training, and revenue cycle optimization. These services were aimed at helping providers understand how to use their EHR to track and improve the quality of care delivered to patients.
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Published:
16 January 2012 |
Keyword(s): Electronic Health Records, Population health, Prevention, Primary Care, United States
Terry AL et al, Canadian Family Physician, 58(6)
The first 3 papers in this series have focused on selecting and implementing an EMR, how the structure of EMR information matters, and how to answer practice-level questions using EMR data. This paper provides a context within which these 3 previous topics might be understood. We take the natural next step in the series by focusing on 5 essential conditions that are necessary for optimal EMR use in both research and patient care.
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Published:
June 2012 |
Keyword(s): Canada, Electronic Health Records, Primary Care
Klompas M et al, American Journal of Preventive Medicine, 42(6, Supplement 2)
Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of public health interest, and automatically communicate results to health departments.
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Published:
12 June 2012 |
Keyword(s): Electronic Health Records, Electronic Medical Records, Primary Care, Public Health, United States
Jariwala KS et al, Research in Social and Administrative Pharmacy, 2012
Background
The impetus of electronic prescribing (e-prescribing) is the reduction of preventable medication errors by generating a legible prescription checked via e-prescribing software for drug-drug and other interactions. Although the adoption of e-prescribing among physicians is growing, the Institute of Medicine’s recommendations that all prescriptions be routed electronically by 2010 certainly has not been met.
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Published:
12 June 2012 |
Keyword(s): Adoption, Electronic Prescribing, Primary Care, United States
Bundy DG et al, Joint Commission Journal on Quality and Patient Safety, 38(5)
BACKGROUND
Timely laboratory monitoring may reduce the potential harm associated with chronic medication use. A study was conducted to determine the proportion of patients receiving National Committee for Quality Assurance (NCQA)-recommended laboratory medication monitoring in a primary care setting and to assess the effect of electronic health record (EHR)-derived, paper-based, provider-specific feedback bulletins on subsequent patient receipt of medication monitoring.
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Published:
May 2012 |
Keyword(s): Electronic Health Records, Medication Safety, Monitoring, Primary Care, United States
O’Malley A et al, Journal of General Internal Medicine, 2012
BACKGROUND
Despite expectations that medical homes provide “24 × 7 coverage” there is little to guide primary care practices in developing sustainable models for accessible and coordinated after–hours care.
OBJECTIVE
To identify and describe models of after-hours care in the U.S. that are delivered in primary care sites or coordinated with a patient’s usual primary care provider.
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Published:
1 June 2012 |
Keyword(s): Electronic Health Records, Primary Care, United States
Pagliari C et al, JRSM short reports, 3(5)
OBJECTIVES
To explore the integration of online patient Record Access within UK Primary Care, its perceived impacts on workload and service quality, and barriers to implementation.
DESIGN
Mixed format survey of clinicians, administrators and patients. Telephone interviews with non-users.
SETTING
Primary care centres within NHS England that had offered online record access for the preceding year.
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Published:
28 May 2012 |
Keyword(s): integration, Patient Record Access, Primary Care, Survey, UK
Samal L et al, The American journal of managed care, 17(9)
OBJECTIVES
Adding clinical decision support (CDS) to electronic health records (EHRs) is required under meaningful use legislation, but there has been little national data on effectiveness in improving clinical outcomes. We sought to determine whether EHRs with CDS improved blood pressure control in US primary care visits. Study Design: We used a cross-sectional, nationally representative survey.
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Published:
September 2011 |
Keyword(s): Blood Pressure, Decision Support Systems, Electronic Health Records, General Practitioner, Hypertension, Primary Care, Statistics, United States
Kern LM, Applied Clinical Informatics, 3(2)
Background:
Health information exchange is a national priority, but there is limited evidence of its effectiveness.
Objective:
We sought to determine the effect of health information exchange on ambulatory quality.
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Published:
30 May 2012 |
Keyword(s): Effectiveness, Health Information Exchange, Primary Care, Quality of Health Care
Linder JA et al, J Am Med Inform Assoc, 2012
Objective
Physicians who more intensively interact with electronic health records (EHRs) through their documentation style may pay greater attention to coded fields and clinical decision support and thus may deliver higher quality care. We measured the quality of care of physicians who used three predominating EHR documentation styles: dictation, structured documentation, and free text.
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Published:
19 May 2012 |
Keyword(s): Documentation, Electronic Health Records, Patient Safety, Physicians, Primary Care, Quality of Health Care
Singh H et al, BMJ Quality and Safety, 21(2)
BACKGROUND
Diagnostic errors in primary care are harmful but difficult to detect. The authors tested an electronic health record (EHR)-based method to detect diagnostic errors in routine primary care practice.
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Published:
13 October 2011 |
Keyword(s): Diagnostic Errors, Electronic Health Records, Primary Care, Retrospective Studies, United States
Crosson JC et al, The Annals of Family Medicine, 10(3)
PURPOSE
Recent efforts to encourage meaningful use of electronic health records (EHRs) assume that widespread adoption will improve the quality of ambulatory care, especially for complex clinical conditions such as diabetes. Cross-sectional studies of typical uses of commercially available ambulatory EHRs provide conflicting evidence for an association between EHR use and improved care, and effects of longer-term EHR use in community-based primary care settings on the quality of care are not well understood.
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Published:
1 May 2012 |
Keyword(s): Diabetes Mellitus, Electronic Health Records, Electronic Medical Records, Medical Record Systems, Primary Care, Quality, United States
