基于健康信息技术的医疗协调：以患者为中心的家庭医疗临床医生全国性调查。
Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians.
作者信息
Morton Suzanne, Shih Sarah C, Winther Chloe H, Tinoco Aldo, Kessler Rodger S, Scholle Sarah Hudson
机构信息
National Committee for Quality Assurance, Washington, DC
Primary Care Information Project, New York City Department of Health and Mental Hygiene, New York, New York.
出版信息
Ann Fam Med. 2015 May-Jun;13(3):250-6. doi: 10.1370/afm.1797.
PURPOSE
Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards.
METHODS
We surveyed physician-owned and hospital/health system-affiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities.
RESULTS
Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practice's capacity for systematic change.
CONCLUSIONS
Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians' priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination.
目的
健康信息技术（IT）为改善护理协调提供了有前景的工具。我们评估了医疗保险和医疗补助服务中心电子健康记录激励计划（有意义使用）第三阶段中与转诊、其他机构护理通知、患者临床摘要和患者仪表板相关的6项拟议护理协调目标的可行性和可接受性。
方法
我们对获得以患者为中心的医疗之家认可并参与有意义使用计划的医生拥有的以及医院/卫生系统附属的初级保健机构，以及获得以患者为中心的医疗之家认可的社区健康诊所（大多数拥有认证电子健康记录系统）进行了调查。回复率为35.1%。我们确定这些机构是否实施了拟议目标以及对其重要性的看法。我们分析了组织和背景因素与自我报告的使用健康IT以支持护理协调活动之间的关联。
结果
尽管350名受访者中有78%认为及时通知医院出院非常重要，但只有48.7%使用健康IT系统来完成这项任务。健康IT最常支持的活动是向患者提供临床摘要，76.6%的机构开展了此项活动；然而，只有47.7%的机构认为这项活动非常重要。更多地使用健康IT来支持护理协调活动与有一名负责护理协调的非临床医生以及机构进行系统变革的能力呈正相关。
结论
即使在对医疗之家模式有坚定承诺的机构中，使用健康IT来支持护理协调目标也不一致。目前健康IT能力与临床医生的优先事项不匹配。许多机构在健康IT方面需要资金和技术援助以加强护理协调。
Zotero 插件