scholarly journals Electronic health records and health care quality over time in a federally qualified health center

2015 ◽  
Vol 22 (2) ◽  
pp. 453-458 ◽  
Author(s):  
Lisa M. Kern ◽  
Alison M. Edwards ◽  
Michelle Pichardo ◽  
Rainu Kaushal
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Electronic Health Records ◽  
Health Center ◽  
Health Care Quality ◽  
Meaningful Use ◽  
Care Quality ◽  
Health Records ◽  
Federally Qualified Health Center ◽  
Electronic Health

Abstract The longitudinal effects of electronic health records (EHRs) on ambulatory quality are not clear. It is not known whether adoption and meaningful use of EHRs result in a brief period of quality improvement that then plateaus, or whether with ongoing use quality improvement continues. We studied health care quality at six sites of a Federally Qualified Health Center in New York State over 3 years (2008–2010) for 25 290 unique patients. Patients were twice as likely to receive recommended care on a set of 12 quality measures (11 of which are included in Stage 1 Meaningful Use) 3 years post-EHR implementation, compared to 1-year post-implementation (odds ratio 1.97; 95% confidence interval, 1.91–2.03). The magnitude of absolute improvement ranged from 5% to 20% per measure. EHRs were associated with continuing improvement in health care quality for at least 3 years post-implementation in the safety-net setting of a Federally Qualified Health Center.

Implementing Health Care Quality Measures in Electronic Health Records: A Conceptual Model

2021 ◽  
Author(s):  
Claire M. Campbell ◽  
Daniel R. Murphy ◽  
George E. Taffet ◽  
Anita B. Major ◽  
Christine S. Ritchie ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Conceptual Model ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Health Records ◽  
Electronic Health

scholarly journals Electronic Health Records as Valuable Data Sources in the Health Care Quality Improvement Process

2019 ◽  
Vol 6 ◽  
pp. 233339281985287 ◽  
Author(s):  
Katja Wikström ◽  
Maija Toivakka ◽  
Päivi Rautiainen ◽  
Hilkka Tirkkonen ◽  
Teppo Repo ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Early Detection ◽  
Electronic Health Records ◽  
Regional Differences ◽  
Health Care Quality ◽  
Data Retrieval ◽  
Care Quality ◽  
Health Records ◽  
Valuable Data ◽  
Electronic Health

Background: In North Karelia, Finland, the regional electronic health records (EHRs) enable flexible data retrieval and area-level analyses. The aim of this study was to assess the early detection of type 2 diabetes (T2D) in the region and to evaluate the performed activities in order to improve the processes between the years 2012 and 2017. Methods: Patients with T2D were identified from the EHRs using the ICD-10 codes registered during any visit to either primary or specialized care. The prevalence of T2D was calculated for the years 2012, 2015, and 2017 on the municipality level. The number of people found in the EHRs with diabetes was compared with the number found in the national register of medication reimbursement rights. Results: In 2012, the age-adjusted prevalence of T2D in North Karelia varied considerably between municipalities (5.5%-8.6%). These differences indicate variation in the processes of early diagnosis. The findings were discussed in the regional network of health professionals treating patients with T2D, resulting in sharing experiences and best practices. In 2017, the differences had notably diminished, and in most municipalities, the prevalence exceeded 8%. The regional differences in the prevalence and their downward trend were observed both in the EHRs and in the medication reimbursement rights register. Conclusion: Clear differences in the prevalence of T2D were detected between municipalities. After visualizing these differences and providing information for the professionals, the early detection of T2D improved and the regional differences decreased. The EHRs are a valuable data source for knowledge-based management and quality improvement.

scholarly journals The Digitization of Patient Care: A Review of the Effects of Electronic Health Records on Health Care Quality and Utilization

2019 ◽  
Vol 40 (1) ◽  
pp. 487-500 ◽  
Author(s):  
Hilal Atasoy ◽  
Brad N. Greenwood ◽  
Jeffrey Scott McCullough
Keyword(s):  
Electronic Health Records ◽  
Health Informatics ◽  
Health Care Quality ◽  
Clinical Care ◽  
Academic Research ◽  
Care Quality ◽  
Health Records ◽  
Policy Practice ◽  
Electronic Health ◽  
Cost Implications

Electronic health records (EHRs) adoption has become nearly universal during the past decade. Academic research into the effects of EHRs has examined factors influencing adoption, clinical care benefits, financial and cost implications, and more. We provide an interdisciplinary overview and synthesis of this literature, drawing on work in public and population health, informatics, medicine, management information systems, and economics. We then chart paths forward for policy, practice, and research.

scholarly journals Towards an Adoption Framework for Patient Access to Electronic Health Records: Systematic Literature Mapping Study

10.2196/15150 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e15150
Author(s):  
Hugo J T van Mens ◽  
Ruben D Duijm ◽  
Remko Nienhuis ◽  
Nicolette F de Keizer ◽  
Ronald Cornet
Keyword(s):  
Electronic Health Records ◽  
Interrater Reliability ◽  
Health Care Quality ◽  
Care Quality ◽  
Patient Access ◽  
System Quality ◽  
Patient Portals ◽  
Health Records ◽  
System Use ◽  
Electronic Health

Background Patient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. Objective We aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF, and assess the interrater reliability. Methods We systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. Results We further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. Conclusions In the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

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