scholarly journals Adoption of an Electronic Medical Record Tool for Childhood Obesity by Primary Care Providers

2020 ◽  
Vol 11 (02) ◽  
pp. 210-217
Author(s):  
Amy Williams ◽  
Christy Turer ◽  
Jamie Smith ◽  
Isabelle Nievera ◽  
Laura McCulloch ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Primary Care Providers ◽  
Perceived Usefulness ◽  
Intention To Use ◽  
Care Providers ◽  
Perceived Usability ◽  
Strongly Agree

Abstract Background Primary care providers are tasked with the increasingly difficult job of addressing childhood obesity during clinic visits. Electronic medical record (EMR)-enabled decision-support tools may aid providers in this task; however, information is needed regarding whether providers perceive such tools to be useful for addressing nutrition and physical activity lifestyle behaviors. Objectives This study aimed to evaluate the usefulness and usability of FitTastic, an EMR-enabled tool to support prevention and management of childhood obesity in primary care. Methods In this mixed-method study, we implemented the FitTastic tool in two primary-care clinics, then surveyed and conducted focused interviews with providers. Validated Technology Acceptance Model perceived usefulness and National Aeronautics and Space Administration (NASA) perceived usability survey questions were e-mailed to 60 providers. In-depth provider interviews with family medicine and pediatric physicians (n = 12) were used to further probe adoption of FitTastic. Results Surveys were completed by 73% of providers (n = 44). The mean score for FitTastic's usefulness was 3.3 (standard deviation [SD] = 0.54, scale 1–5, where 5 is strongly agree) and usability, 4.8 (SD = 0.86, scale 1–7, where 7 is strongly agree). Usefulness and usability scores were associated with intention to use FitTastic (correlation for both, p < 0.05). Data from provider interviews indicated that useful features of FitTastic included: standardizing the approach to childhood obesity, and facilitating conversations about weight management, without increasing cognitive workload. However, use of FitTastic required more time from nurses to input lifestyle data. Conclusion FitTastic is perceived as a useful and usable EMR-based lifestyle behavior tool that standardizes, facilitates, and streamlines healthy lifestyle conversations with families. Perceived usability and usefulness scores correlated with provider intention-to-use the technology. These data suggest that EMR-based child obesity prevention and management tools can be feasible to use in the clinic setting, with potential for scalability. Usefulness can be optimized by limiting amount of time needed by staff to input data.

Insights From an Usability Review of an Electronic Medical Record–Integrated Physical Activity Counseling Tool for Primary Care

2020 ◽  
pp. 106480462098214
Author(s):  
Bobby Neudorf ◽  
Lora Giangregorio ◽  
Plinio Morita
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Primary Care Providers ◽  
Care Plan ◽  
Care Providers ◽  
Physical Activity Counseling ◽  
Activity Counseling ◽  
Workflow Integration

This study assessed primary care providers’ (PCPs) perceptions of the usability of an electronic medical record tool to support physical activity counseling in primary care. Our analyses revealed that usability improved when the electronic medical record tool followed a PCP’s natural workflow and when the tool could assist in engaging in a discussion about physical activity. Poor usability was associated with the presence of large amounts of text on the screen and technological aspects that required additional learning. Overall, efficiency, workflow integration, and the inclusion of a care plan were vital in a physical activity counseling tool for a primary care setting.

scholarly journals The Differing Effect of Gender and Clinical Specialty on Physicians' Intention to Use Electronic Medical Record

2019 ◽  
Vol 58 (S 02) ◽  
pp. e58-e71 ◽  
Author(s):  
Hsin-Ginn Hwang ◽  
Bireswar Dutta ◽  
Hui-chuan Chang
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Financial Incentives ◽  
Perceived Usefulness ◽  
Equation Modeling ◽  
Path Coefficient ◽  
Intention To Use ◽  
Care Providers ◽  
Clinical Specialty ◽  
Research Framework

Abstract Background The use of electronic medical record (EMR) is anticipated to bring benefits for patients, physicians, and organizations. But limited physicians' acceptance of EMR presents a serious threat to its effective implementation. Objectives The current study incorporates technology acceptance model (TAM) with two antecedents, gender, and clinical specialty and one context-specific factor, financial incentives, to identify the factors that influence physicians' intention to use EMR in Taiwan. Methods The survey methodology was used to collect data from the physicians, working in the regional hospital that had implemented EMR system. A total of 119 out of 213 questionnaires returned in a response rate of 56%. But four responses were considered ineffective due to missing values. The structural equation modeling (SEM) technique was employed to analyze the research framework. Results The partial least squares (PLS) regression indicated that three factors perceived usefulness, financial incentives, and attitude toward using EMR significantly affect physicians' intention. But concerning perceived ease of use (PEOU), an insignificant path coefficient was reported. Additionally, regression analysis showed gender, and clinical specialty positively influenced physicians' intention to use EMR. Discussion and Conclusions The proposed research framework contributes to the conclusive explanation for interpreting physicians' intention to use EMR. Physicians generally have a higher level of computer literacy. Therefore, the factor of PEOU could not be critical regarding adopting new health information technology (HIT). This study also brings perspectives from the gender, and clinical differences have primarily been missing in the literature of the physicians' intention to use HIT. In doing so, it infers how gender, and clinical specialty, may complement (and in some instances, reinforce) the influence of technological and attitudinal factors of HIT use. Thus, health care providers must take these factors into consideration in the development and validation of the theories regarding the intention to use EMR.

scholarly journals Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System’s Electronic Medical Record

2016 ◽  
Vol 07 (04) ◽  
pp. 969-982 ◽  
Author(s):  
Yhenneko Taylor ◽  
Hazel Tapp ◽  
Thomas Ludden ◽  
Lindsay Shade ◽  
Beth Burton ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
School Health ◽  
Electronic Communication ◽  
Care Program ◽  
Primary Care Providers ◽  
School Nurse ◽  
School Nurses ◽  
Care Providers

SummaryObjective Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient’s treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation. The implementation process and the potential impact of the communication with providers on the reoccurrence of asthma exacerbations with the linked patients were evaluated.Methods By engaging stakeholders from the school system and the healthcare system, we were able to collaboratively design a communication process and implement a pilot which demonstrated the feasibility of electronic communication between school nurses and primary care providers. Outcomes data was collected from the electronic medical record to examine the frequency of asthma exacerbations among patients with a message from their school nurse. The percent of exacerbations in the 12 months before and after electronic communication was compared using McNemar’s test.ResultsThe pilot system successfully established communication between the school nurse and primary care provider for 33 students who had been hospitalized for asthma and a decrease in hospital admissions was observed with students whose school nurse communicated through the EMR with the primary care provider.Conclusions Findings suggest a collaborative model of care that is enhanced through electronic communication via the EMR could positively impact the health of children with asthma or other chronic illnesses.Citation: Reeves KW, Taylor Y, Tapp H, Ludden T, Shade LE, Burton B, Courtlandt C, Dulin M. Evaluation of a pilotasthma care program for electronic communication between school health and a healthcare system’s electronic medicalrecord.

scholarly journals Patient Safety Perceptions of Primary Care Providers after Implementation of an Electronic Medical Record System

2012 ◽  
Vol 28 (2) ◽  
pp. 184-192 ◽  
Author(s):  
Maura J. McGuire ◽  
Gary Noronha ◽  
Lipika Samal ◽  
Hsin-Chieh Yeh ◽  
Susan Crocetti ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Primary Care Providers ◽  
Electronic Medical Record System ◽  
Care Providers ◽  
Record System ◽  
Safety Perceptions ◽  
Medical Record System

Use of an Electronic Medical Record System to Support Primary Care Recommendations to Prevent, Identify, and Manage Childhood Obesity

PEDIATRICS ◽  
2008 ◽  
Vol 123 (Supplement 2) ◽  
pp. S100-S107 ◽  
Author(s):  
Karyl Thomas Rattay ◽  
Meena Ramakrishnan ◽  
Aguida Atkinson ◽  
Megan Gilson ◽  
Vonna Drayton
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record System ◽  
Record System ◽  
Medical Record System

scholarly journals Expanding the Role of Primary Care in the Prevention and Treatment of Childhood Obesity: A Review of Clinic- and Community-Based Recommendations and Interventions

2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Michaela Vine ◽  
Margaret B. Hargreaves ◽  
Ronette R. Briefel ◽  
Cara Orfield
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Weight Status ◽  
Primary Care Providers ◽  
Infrastructure Development ◽  
Institute Of Medicine ◽  
Care Providers ◽  
Community Settings ◽  
Community Based ◽  
Prevention And Treatment

Although pediatric providers have traditionally assessed and treated childhood obesity and associated health-related conditions in the clinic setting, there is a recognized need to expand the provider role. We reviewed the literature published from 2005 to 2012 to (1) provide examples of the spectrum of roles that primary care providers can play in the successful treatment and prevention of childhood obesity in both clinic and community settings and (2) synthesize the evidence of important characteristics, factors, or strategies in successful community-based models. The review identified 96 articles that provide evidence of how primary care providers can successfully prevent and treat childhood obesity by coordinating efforts within the primary care setting and through linkages to obesity prevention and treatment resources within the community. By aligning the most promising interventions with recommendations published over the past decade by the Institute of Medicine, the American Academy of Pediatrics, and other health organizations, we present nine areas in which providers can promote the prevention and treatment of childhood obesity through efforts in clinical and community settings: weight status assessment and monitoring, healthy lifestyle promotion, treatment, clinician skill development, clinic infrastructure development, community program referrals, community health education, multisector community initiatives, and policy advocacy.

scholarly journals Cost-Effectiveness of a Clinical Childhood Obesity Intervention

2018 ◽  
pp. 136-152
Author(s):  
Mona Sharifi ◽  
Calvin Franz ◽  
Christine M. Horan ◽  
Catherine M. Giles ◽  
Michael W. Long ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Cost Effectiveness ◽  
Childhood Obesity ◽  
Primary Care Providers ◽  
Obesity Prevalence ◽  
Care Providers ◽  
Obesity Intervention ◽  
National Implementation ◽  
Behavior Change Support

OBJECTIVES To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity. METHODS In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care. We used a microsimulation model of a national implementation of STAR from 2015 to 2025 among all pediatric primary care providers in the United States with fully functional EHRs to estimate cost, impact on obesity prevalence, and cost-effectiveness. RESULTS The expected population reach of a 10-year national implementation is ∼2 million children, with intervention costs of $119 per child and $237 per BMI unit reduced. At 10 years, assuming maintenance of effect, the intervention is expected to avert 43 000 cases and 226 000 life-years with obesity at a net cost of $4085 per case and $774 per life-year with obesity averted. Limiting implementation to large practices and using higher estimates of EHR adoption improved both cost-effectiveness and reach, whereas decreasing the maintenance of the intervention’s effect worsened the former. CONCLUSIONS A childhood obesity intervention with electronic decision support for clinicians and self-guided behavior-change support for parents may be more cost-effective than previous clinical interventions. Effective and efficient interventions that target children with obesity are necessary and could work in synergy with population-level prevention strategies to accelerate progress in reducing obesity prevalence.

scholarly journals 1174 Assessing Sleep Disorders in Primary Care: A Provider Survey About the Importance of Sleep Health

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A448-A448
Author(s):  
K J Klingman ◽  
A Morse ◽  
N Williams ◽  
M A Grandner ◽  
M L Perlis
Keyword(s):  
Primary Care ◽  
Sleep Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Multiple Choice Questions ◽  
Sleep Health ◽  
Provider Characteristics ◽  
Comfort Levels ◽  
Provider Survey ◽  
Strongly Agree

Abstract Introduction Conditions commonly managed by primary care providers (PCPs) such as depression, diabetes, and heart disease, commonly co-occur with sleep disorders. If PCPs could readily identify comorbid sleep disorders in this context, it may provide a pathway to more effective management of both types of disorders. Currently, it is unknown what might encourage or discourage PCPs from routinely screening their patients for sleep disorders. Methods PCPs from UPENN and GHS completed surveys regarding sleep health. The 30-item instrument comprised demographic, 14 VAS (0%-100%=strongly disagree-strongly agree), 4 open-ended, 3 yes/no, and 2 multiple-choice questions. Results Ninety-nine PCPs responded and were predominately female (61% F, 37%M, 2% other), Caucasian (81%), on-average 45yrs old (25-70) and in primary care for 16yrs (1-43). Fifty-six percent were MDs, 21%DOs, 17%PAs, and 6%NPs. PCPs rated sleep disorders as highly important for cardiopulmonary, mental, and general health (85, 84, & 83%), with no difference (per linear regression, p&gt;0.05) according to system or provider characteristics. PCPs reported high importance for knowing about and diagnosing sleep disorders (88% & 82%) within their practices. Lower comfort levels were reported for discussing (78%) sleep disorders, overseeing/following (62%), diagnosing (60%), or treating (48%) patients. Eighty percent of PCPs stated an efficient sleep disorders screener would be useful for their practice; this perception varied (per logistic regression) according to provider credentials (Wald=0.037) and Hispanic/Latino ethnicity (Wald=0.025). PCPs reported time constraints limit their responsiveness to sleep disorders Conclusion A large disparity exists between the importance PCPs place on sleep disorders and their low comfort levels with following, diagnosing, and treating sleep disorders. PCPs endorsed the need to have available an efficient sleep disorders screener to use in their practice. Support No funding was received for this study.

scholarly journals Educational Interventions to Improve Advance Care Planning Discussions, Documentation and Billing

2020 ◽  
pp. 104990912095108
Author(s):  
Cristine B. Henage ◽  
J. Marvin McBride ◽  
Joseph Pino ◽  
Jessica Williams ◽  
Jill Vedovi ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Advance Care Planning ◽  
Primary Care Providers ◽  
Educational Interventions ◽  
Care Planning ◽  
Interprofessional Team ◽  
Advance Care

Background/Objectives: To determine the impact of educational interventions, clinic workflow redesign, and quality improvement coaching on the frequency of advance care planning (ACP) activities for patients over the age of 65. Design: Nonrandomized before-and-after study. Setting: 13 ambulatory care clinics with 81 primary care providers in eastern and central North Carolina. Participants: Patients across 13 primary care clinics staffed by 66 physicians, 8 physician assistants and 7 family nurse practitioners. Interventions: Interprofessional, interactive ACP training for the entire interprofessional team and quality improvement project management with an emphasis on workflow redesign. Measurements: From July 2017 through June 2018—number of ACP discussions, number of written ACP documents incorporated into the electronic medical record (EMR), number of ACP encounters billed. Results: Following the interventions, healthcare providers were more than twice as likely to conduct ACP discussions with their patients. Patients were 1.4 times more likely to have an ACP document included in their electronic medical record. Providers were significantly ( p < 0.05) more likely to bill for an ACP encounter in only one clinic. Conclusions: Implementing ACP education for all clinic staff, planning for workflow changes to involve the entire interprofessional team and supporting ACP activities with quality improvement coaching leads to statistically significant improvements in the frequency of ACP discussions, the number of ACP documents included in the electronic medical record and number of ACP encounters billed.

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