Begum Rohima, Smith Ryan Mandy, Winther Chloe H, Wang Jason J, Bardach Naomi S, Parsons Amanda H, Shih Sarah C, Dudley R Adams
New York City Department of Health and Mental Hygiene, Primary Care Information Project, 42-09 28th St, 12th Fl, Queens, NY 11101. E-mail:
Am J Manag Care. 2013 Nov;19(10 Spec No):eSP12-8.
To assess clinician attitudes and experiences in Health eHearts, a quality recognition and financial incentive program using health information technology.
Survey of physicians.
A survey was administered to 140 lead clinicians at each participating practice. Survey domains included clinicians' experiences and attitudes toward the selected clinical quality measures focused on cardiovascular care, use of electronic health records (EHRs), technical assistance visits, quality measurement reports, and incentive payments. Responses were compared across groups of practices receiving financial incentives with those in the control (no financial rewards).
Survey response rate was 74%. The majority of respondents reported receiving and reviewing the quality reports (89%), agreed with the prioritization of measures (89%), and understood the information given in the quality reports (95%). Over half of the respondents had a quality improvement visit (56%), with incentive clinicians more likely to have had a visit compared with the control group (68% vs 43%, P = .01). The incentive group respondents (92%) were more likely to report using clinical decision support system alerts than control group respondents (82%, P = .11).
Clinicians in both incentive and control groups reported positive experiences with the program. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population. However, clinicians in the incentive group were more likely to review quarterly performance reports and access quality improvement visits. Incentives may be used to further engage clinicians operating in small independently owned practices to participate in quality improvement activities.
评估临床医生对“健康之心”项目的态度和体验，这是一个利用健康信息技术的质量认可和经济激励项目。
对医生进行调查。
对每个参与机构的140名主要临床医生进行调查。调查领域包括临床医生对选定的以心血管护理为重点的临床质量指标的体验和态度、电子健康记录（EHR）的使用、技术援助访问、质量测量报告以及激励支付。将获得经济激励的机构组与对照组（无经济奖励）的回答进行比较。
调查回复率为74%。大多数受访者报告收到并查看了质量报告（89%），同意指标的优先排序（89%），并理解质量报告中给出的信息（95%）。超过一半的受访者进行了质量改进访问（56%），与对照组相比，获得激励的临床医生更有可能进行过访问（68%对43%，P = 0.01）。获得激励组的受访者（92%）比对照组受访者（82%，P = 0.11）更有可能报告使用临床决策支持系统警报。
激励组和对照组的临床医生都报告了对该项目的积极体验。在对选定临床指标的认同或其与患者群体的相关性方面，两组之间未发现差异。然而，激励组的临床医生更有可能查看季度绩效报告并获得质量改进访问。激励措施可用于进一步促使在小型独立执业机构工作的临床医生参与质量改进活动。
