scholarly journals The Association of Electronic Health Record Adoption with Staffing Mix in Community Health Centers

2017 ◽  
Vol 52 ◽  
pp. 407-421 ◽  
Author(s):  
Bianca K. Frogner ◽  
Xiaoli Wu ◽  
Jeongyoung Park ◽  
Patricia Pittman
Keyword(s):  
Electronic Health Record ◽  
Community Health ◽  
Community Health Centers ◽  
Health Centers ◽  
Health Record ◽  
Staffing Mix ◽  
Electronic Health

scholarly journals Using the electronic health record for assessment of health insurance in community health centers

2016 ◽  
Vol 23 (5) ◽  
pp. 984-990 ◽  
Author(s):  
Brigit Hatch ◽  
Carrie Tillotson ◽  
Heather Angier ◽  
Miguel Marino ◽  
Megan Hoopes ◽  
...  
Keyword(s):  
Health Insurance ◽  
Electronic Health Record ◽  
Community Health ◽  
Community Health Centers ◽  
Health Centers ◽  
Health Record ◽  
Poverty Level ◽  
National Network ◽  
Factors Associated ◽  
Electronic Health

Abstract Objective To demonstrate use of the electronic health record (EHR) for health insurance surveillance and identify factors associated with lack of coverage. Materials and Methods Using EHR data, we conducted a retrospective, longitudinal cohort study of adult patients ( n  = 279 654) within a national network of community health centers during a 2-year period (2012–2013). Results Factors associated with higher odds of being uninsured (vs Medicaid-insured) included: male gender, age >25 years, Hispanic ethnicity, income above the federal poverty level, and rural residence ( P  < .01 for all). Among patients with no insurance at their initial visit ( n  = 114 000), 50% remained uninsured for every subsequent visit. Discussion During the 2 years prior to 2014, many patients utilizing community health centers were unable to maintain stable health insurance coverage. Conclusion As patients gain access to health insurance under the Affordable Care Act, the EHR provides a novel approach to help track coverage and support vulnerable patients in gaining and maintaining coverage.

scholarly journals Workflow analysis for design of an electronic health record-based tobacco cessation intervention in community health centers

JAMIA Open ◽  
2021 ◽  
Author(s):  
Bryan Gibson ◽  
Heidi Kramer ◽  
Charlene Weir ◽  
Guilherme Fiol ◽  
Damian Borbolla ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Community Health ◽  
Community Health Centers ◽  
Tobacco Cessation ◽  
Community Health Center ◽  
The United States ◽  
Health Record ◽  
Group Discussions ◽  
Medical Assistants ◽  
Electronic Health

Abstract Objective Tobacco use is the leading cause of preventable morbidity and mortality in the United States. Quitlines are effective telephone-based tobacco cessation services but are underutilized. The goal of this project was to describe current clinical workflows for Quitline referral and design an optimal electronic health record (EHR)-based workflow for Ask-Advice-Connect (AAC), an evidence-based intervention to increase Quitline referrals. Materials and methods Ten Community Health Center systems (CHC), which use three different EHRs, participated in this study. Methods included: 9 group discussions with CHC leaders; 33 observations/interviews of clinical teams' workflow; surveys with 57 clinical staff; and assessment of the EHR ecosystem in each CHC. Data across these methods were integrated and coded according to the Fit between Individual, Task, Technology and Environment (FITTE) framework. The current and optimal workflow were notated using Business Process Modelling Notation. We compared the requirements of the optimal workflow with EHR capabilities. Results Current workflows are inefficient in data collection, variable in who, how, and when tobacco cessation advice and referral are enacted, and lack communication between referring clinics and the Quitline. In the optimal workflow, medical assistants deliver a standardized AAC intervention during the visit intake. Referrals are submitted electronically, and there is bidirectional communication between the clinic and Quitline. We implemented AAC within all three EHRs; however, deviations from the optimal workflow were necessary. Conclusion Current workflows for Quitline referral are inefficient and ineffective. We propose an optimal workflow and discuss improvements in EHR capabilities that would improve the implementation of AAC.

scholarly journals Assessing the Impact of Innovative Training of Family Physicians for the Patient-Centered Medical Home

2012 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Patricia A. Carney ◽  
M. Patrice Eiff ◽  
John W. Saultz ◽  
Erik Lindbloom ◽  
Elaine Waller ◽  
...  
Keyword(s):  
Medical School ◽  
Electronic Health Record ◽  
Medical Home ◽  
The United States ◽  
Health Centers ◽  
Health Record ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Residency Programs ◽  
Electronic Health

Abstract Background New approaches to enhance access in primary care necessitate change in the model for residency education. Purpose To describe instrument design, development and testing, and data collection strategies for residency programs, continuity clinics, residents, and program graduates participating in the Preparing the Personal Physician for Practice (P4) project. Methods We developed and pilot-tested surveys to assess demographic characteristics of residents, clinical and operational features of the continuity clinics and educational programs, and attitudes about and implementation status of Patient Centered Medical Home (PCMH) characteristics. Surveys were administered annually to P4 residency programs since the project started in 2007. Descriptive statistics were used to profile data from the P4 baseline year. Results Most P4 residents were non-Hispanic white women (60.7%), married or partnered, attended medical school in the United States and were the first physicians in their families to attend medical school. Nearly 85% of residency continuity clinics were family health centers, and about 8% were federally qualified health centers. The most likely PCMH features in continuity clinics were having an electronic health record and having fully secure remote access available; both of which were found in more than 50% of continuity clinics. Approximately one-half of continuity clinics used the electronic health record for safety projects, and nearly 60% used it for quality-improvement projects. Conclusions We created a collaborative evaluation model in all 14 P4 residencies. Successful implementation of new surveys revealed important baseline features of residencies and residents that are pertinent to studying the effects of new training models for the PCMH.

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