Cohen Genna R, Adler-Milstein Julia
School of Public Health (Health Management and Policy), University of Michigan, Ann Arbor, MI.
School of Information and School of Public Health (Health Management and Policy), University of Michigan, Ann Arbor, MI
J Am Med Inform Assoc. 2016 Apr;23(e1):e146-51. doi: 10.1093/jamia/ocv147. Epub 2015 Nov 13.
Stage 2 and proposed Stage 3 meaningful use criteria ask providers to support patient care coordination by electronically generating, exchanging, and reconciling key information during patient care transitions.
A stratified random sample of primary care practices in Michigan (n = 328) that had already met Stage 1 meaningful use criteria was surveyed, in order to identify the anticipated barriers to meeting these criteria as well as the expected impact on patient care coordination from doing so.
The top three barriers, as identified by >65% of the primary care providers surveyed, were difficulty sending and receiving patient information electronically, a lack of provider and practice staff time, and the complex workflow changes required. Despite these barriers, primary care providers expressed strong agreement that meeting the proposed Stage 3 care coordination criteria would improve their patients' treatment and ensure they know about their patients' visits to other providers.
The survey results suggest the need to enhance policy approaches and organizational strategies to address the key barriers identified by providers and practices in order to realize important care coordination benefits.
第二阶段以及拟议中的第三阶段的有意义使用标准要求医疗服务提供者在患者护理过渡期间通过电子方式生成、交换和核对关键信息来支持患者护理协调。
对密歇根州已经符合第一阶段有意义使用标准的基层医疗实践进行分层随机抽样调查（n = 328），以确定满足这些标准的预期障碍以及这样做对患者护理协调的预期影响。
超过65%的接受调查的基层医疗服务提供者认为，排名前三的障碍是电子方式发送和接收患者信息困难、医疗服务提供者和实践工作人员时间不足以及所需的复杂工作流程变更。尽管存在这些障碍，基层医疗服务提供者仍强烈认同，满足拟议中的第三阶段护理协调标准将改善患者治疗并确保他们了解患者去其他医疗服务提供者处就诊的情况。
调查结果表明，需要加强政策措施和组织策略，以解决医疗服务提供者和实践中发现的关键障碍，从而实现重要的护理协调效益。
