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评价电子健康记录转介流程,以增强参与基于证据的关节炎干预措施的效果。

Evaluation of an Electronic Health Record Referral Process to Enhance Participation in Evidence-Based Arthritis Interventions.

机构信息

National Recreation and Park Association, Programs and Partnerships, Ashburn, Virginia.

Now with Administration for Community Living, Department of Health and Human Services, Washington, District of Columbia.

出版信息

Prev Chronic Dis. 2021 May 13;18:E46. doi: 10.5888/pcd18.200484.

Abstract

PURPOSE AND OBJECTIVES

Effective community-based programs to manage arthritis exist, but many adults with arthritis are unaware that these programs are available in their communities. An electronic health record (EHR) referral intervention was designed to strengthen health care and community-based partnerships and increase participation in these arthritis programs. The intervention was developed in response to a national effort that aimed to enhance the health, wellness, and quality of life for people with arthritis by increasing the awareness and availability of, and participation in arthritis-appropriate evidence-based interventions.

INTERVENTION APPROACH

The National Recreation and Park Association recruited 4 park and recreation agencies and their health care partners to implement an EHR-based retrospective and point-of-care referral intervention. Eligible for referral were adults aged 45 or older with an arthritis condition who were seen by a physician within the past 18 months, and were living within the park and recreation service area. After health care organizations identified eligible adults, they either mailed communication packages describing the availability and benefits of the intervention and conducted phone calls to encourage arthritis-appropriate intervention participation or counseled and referred patients during an office visit.

EVALUATION METHODS

The pilot was assessed by using semi-structured interviews with key intervention staff members and the Consolidated Framework for Implementation Research.

RESULTS

Our approach resulted in referrals for 3,660 people, 1,063 (29%) of whom participated in an intervention. Analysis of key informant interviews also highlighted the specific contextual factors, facilitators, and barriers that influenced the adaptation and overall implementation of the referral intervention.

IMPLICATIONS FOR PUBLIC HEALTH

Our pilot demonstrates that successful coordination between health care organizations and community-based organizations can promote awareness of and participation in community-based programs. An understanding of the contextual factors and lessons learned can be used to inform processes that can lead to more effective and sustainable health care and community-based partnerships.

摘要

目的和目标

有效的基于社区的关节炎管理项目确实存在,但许多关节炎患者并不知道他们所在社区有这些项目。电子健康记录 (EHR) 转介干预旨在加强医疗保健和基于社区的合作伙伴关系,并增加对这些关节炎项目的参与。该干预措施是针对一项国家努力而制定的,该努力旨在通过提高人们对关节炎的认识和可用性,以及增加对关节炎的适当循证干预措施的参与度,来提高关节炎患者的健康、健康和生活质量。

干预方法

全国娱乐和公园协会招募了 4 个公园和娱乐机构及其医疗保健合作伙伴,以实施基于 EHR 的回顾性和即时转介干预措施。有资格转介的是年龄在 45 岁或以上、过去 18 个月内看过医生、居住在公园和娱乐服务区内的关节炎患者。在医疗保健组织确定符合条件的成年人后,他们要么邮寄描述干预措施的可用性和益处的通讯包,并进行电话通话以鼓励参与关节炎的适当干预措施,要么在就诊时对患者进行咨询和转介。

评估方法

采用半结构化访谈和综合实施研究框架对试点进行评估。

结果

我们的方法导致了 3660 人的转介,其中 1063 人(29%)参与了干预措施。对主要信息提供者的访谈分析也突出了影响转介干预措施的适应和整体实施的具体背景因素、促进因素和障碍。

对公共卫生的影响

我们的试点表明,医疗保健组织和基于社区的组织之间的成功协调可以提高对基于社区的项目的认识和参与度。对背景因素和经验教训的理解可以用于告知可以导致更有效和可持续的医疗保健和基于社区的伙伴关系的过程。

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