scholarly journals Return on Investment in Electronic Health Records in Primary Care Practices: A Mixed-Methods Study

2014 ◽  
Vol 2 (2) ◽  
pp. e25 ◽  
Author(s):  
Yeona Jang ◽  
Michel A Lortie ◽  
Steven Sanche
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Electronic Health Records ◽  
Return On Investment ◽  
Mixed Methods Study ◽  
Health Records ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices

scholarly journals Electronic Health Records and Patient Safety

2015 ◽  
Vol 06 (01) ◽  
pp. 136-147 ◽  
Author(s):  
D. Gans ◽  
J. White ◽  
R. Nath ◽  
J. Pohl ◽  
C. Tanner
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Electronic Health Records ◽  
Medication Management ◽  
Health Records ◽  
Safety Practices ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices ◽  
Promote Patient Safety

Summary Background: The role of electronic health records (EHR) in enhancing patient safety, while substantiated in many studies, is still debated. Objective: This paper examines early EHR adopters in primary care to understand the extent to which EHR implementation is associated with the workflows, policies and practices that promote patient safety, as compared to practices with paper records. Early adoption is defined as those who were using EHR prior to implementation of the Meaningful Use program. Methods: We utilized the Physician Practice Patient Safety Assessment (PPPSA) to compare primary care practices with fully implemented EHR to those utilizing paper records. The PPPSA measures the extent of adoption of patient safety practices in the domains: medication management, handoffs and transition, personnel qualifications and competencies, practice management and culture, and patient communication. Results: Data from 209 primary care practices responding between 2006–2010 were included in the analysis: 117 practices used paper medical records and 92 used an EHR. Results showed that, within all domains, EHR settings showed significantly higher rates of having workflows, policies and practices that promote patient safety than paper record settings. While these results were expected in the area of medication management, EHR use was also associated with adoption of patient safety practices in areas in which the researchers had no a priori expectations of association. Conclusions: Sociotechnical models of EHR use point to complex interactions between technology and other aspects of the environment related to human resources, workflow, policy, culture, among others. This study identifies that among primary care practices in the national PPPSA database, having an EHR was strongly empirically associated with the workflow, policy, communication and cultural practices recommended for safe patient care in ambulatory settings. Citation: Tanner C, Gans D, White J, Nath R, Pohl J. Electronic health records and patient safety – co-occurrence of early EHR implementation with patient safety practices in primary care settings. Appl Clin Inf 2015; 6: 136–147http://dx.doi.org/10.4338/ACI-2014-11-RA-0099

The Financial And Nonfinancial Costs Of Implementing Electronic Health Records In Primary Care Practices

2011 ◽  
Vol 30 (3) ◽  
pp. 481-489 ◽  
Author(s):  
Neil S. Fleming ◽  
Steven D. Culler ◽  
Russell McCorkle ◽  
Edmund R. Becker ◽  
David J. Ballard
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices

scholarly journals Scaling-up social needs screening in practice: a retrospective, cross-sectional analysis of data from electronic health records from Bronx county, New York, USA

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053633
Author(s):  
Kevin P Fiori ◽  
Caroline G Heller ◽  
Anna Flattau ◽  
Nicole R Harris-Hollingsworth ◽  
Amanda Parsons ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Electronic Health Records ◽  
Social Care ◽  
Social Needs ◽  
Cross Sectional ◽  
Health Records ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices

ObjectivesThere has been renewed focus on health systems integrating social care to improve health outcomes with relatively less related research focusing on ‘real-world’ practice. This study describes a health system’s experience from 2018 to 2020, following the successful pilot in 2017, to scale social needs screening of patients within a large urban primary care ambulatory network.SettingAcademic medical centre with an ambulatory network of 18 primary care practices located in an urban county in New York City (USA).ParticipantsThis retrospective, cross-sectional study used electronic health records of 244 764 patients who had a clinical visit between 10 April 2018 and 8 December 2019 across any one of 18 primary care practices.MethodsWe organised measures using the RE-AIM framework domains of reach and adoption to ascertain the number of patients who were screened and the number of providers who adopted screening and associated documentation, respectively. We used descriptive statistics to summarise factors comparing patients screened versus those not screened, the prevalence of social needs screening and adoption across 18 practices.ResultsBetween April 2018 and December 2019, 53 093 patients were screened for social needs, representing approximately 21.7% of the patients seen. Almost one-fifth (19.6%) of patients reported at least one unmet social need. The percentage of screened patients varied by both practice location (range 1.6%–81.6%) and specialty within practices. 51.8% of providers (n=1316) screened at least one patient.ConclusionsThese findings demonstrate both the potential and challenges of integrating social care in practice. We observed significant variability in uptake across the health system. More research is needed to better understand factors driving adoption and may include harmonising workflows, establishing unified targets and using data to drive improvement.

Electronic Health Records are Associated with Higher Quality in Primary Care Practices

2009 ◽  
Author(s):  
Mark Friedberg ◽  
Kathryn Coltin ◽  
Dana Safran ◽  
Marguerite Dresser ◽  
Alan Zaslavsky ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices

scholarly journals The Impact of Electronic Health Records on Workflow and Financial Measures in Primary Care Practices

2013 ◽  
Vol 49 (1pt2) ◽  
pp. 405-420 ◽  
Author(s):  
Neil S. Fleming ◽  
Edmund R. Becker ◽  
Steven D. Culler ◽  
Dunlei Cheng ◽  
Russell McCorkle ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Financial Measures ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices ◽  
The Impact

scholarly journals Routinely asking patients about income in primary care: a mixed-methods study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0090
Author(s):  
Andrew David Pinto ◽  
Erica Shenfeld ◽  
Tatiana Aratangy ◽  
Ri Wang ◽  
Rosane Nisenbaum ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Electronic Health Records ◽  
Social Determinant ◽  
Mixed Methods Study ◽  
Financial Strain ◽  
Future Research ◽  
Care Organization ◽  
Health Records ◽  
Electronic Health

BackgroundIncome is a key social determinant of health yet it is rare for data on income to be routinely collected and integrated with electronic health records.AimTo examine response bias and evaluate patient perspectives of being asked about income in primary care.Design and settingMixed-methods study in a large, multi-site primary care organization in Toronto, Canada where patients are asked about income in a routinely administered sociodemographic survey.MethodsWe examined data from the electronic health records of patients who answered at least one question on the survey between December 2013 and March 2016 (n=14,247). We compared those who responded to the income question to non-responders. We also conducted structured interviews with 27 patients.Results10,441 (73%) patients responded to both parts of the income question. Female patients, minorities, caregivers of young children and seniors were less likely to respond. From interviews, many patients were comfortable answering the income question, particularly if they understood the connection between income and health, and believed the data would be used to improve care. Several patients found it difficult to estimate their income or felt the options did not reflect fluctuating financial circumstances.ConclusionsMany patients will provide data on income in the context of a survey in primary care, but accurately estimating income can be challenging. Future research should compare self-reported income to perceived financial strain. Data on income linked to health records can help identify health inequities and can help target anti-poverty interventions.

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