Effect on VA Patient Satisfaction of Provider’s Use of an Integrated Viewer of Multiple Electronic Health Records

Legler, Aaron; Price, Megan; Parikh, Megha; Nebeker, Jonathan R.; Ward, Merry; Wedemeyer, Linda; Pizer, Steven D.

doi:10.1007/s11606-018-4708-z

Cited by 23 publications

(19 citation statements)

References 9 publications

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“…Improved access to patient information and records was reported as a benefit following EHR/PHR implementation [17,34,37,45,48,56,65,69,75,90,91,99,101,128,147,150,153]. Nurses perceived that increased accessibility enhanced their job performance [20,28].…”

Section: Accessibilitymentioning

confidence: 99%

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Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Tsai

Eghdam

Davoody

et al. 2020

Life

117

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Despite the great advances in the field of electronic health records (EHRs) over the past 25 years, implementation and adoption challenges persist, and the benefits realized remain below expectations. This scoping review aimed to present current knowledge about the effects of EHR implementation and the barriers to EHR adoption and use. A literature search was conducted in PubMed, Web of Science, IEEE Xplore Digital Library and ACM Digital Library for studies published between January 2005 and May 2020. In total, 7641 studies were identified of which 142 met the criteria and attained the consensus of all researchers on inclusion. Most studies (n = 91) were published between 2017 and 2019 and 81 studies had the United States as the country of origin. Both positive and negative effects of EHR implementation were identified, relating to clinical work, data and information, patient care and economic impact. Resource constraints, poor/insufficient training and technical/educational support for users, as well as poor literacy and skills in technology were the identified barriers to adoption and use that occurred frequently. Although this review did not conduct a quality analysis of the included papers, the lack of uniformity in the use of EHR definitions and detailed contextual information concerning the study settings could be observed.

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Section: Accessibilitymentioning

confidence: 99%

“…Enhanced quality of care following EHR/PHR adoption was suggested [17,24,27,43,45,46,49,57,64,67,75,84,85,107,111,112,115,128,131,133,135,146,150,153]. A randomized trial suggested a significantly lower prevalence in all-cause 30-day readmissions in patients who adopted PHR as compared to non-adopters [88].…”

Section: Quality Of Carementioning

confidence: 99%

Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Tsai

Eghdam

Davoody

et al. 2020

Life

117

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“…12 Legler and colleagues found an association between patient satisfaction and provider's use of an integrated viewer of multiple electronic health records. 13 Regarding workload, Kabdiyeva found an association between patients seen per provider and burnout. 14 Based on her work, we can postulate that increasing provider workload by requiring providers to see patients more often may result in increased provider burnout.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Follow-up Appointments and Access to Primary Care

2020

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BACKGROUND: Health care operations managers need to balance scheduling frequent follow-ups for patients with chronic conditions and fitting in patients requiring care for new complaints. OBJECTIVE: We quantify how frequency of follow-up visits corresponds with access to care for patients receiving care from the Department of Veterans Affairs (VA). DESIGN: We use patient data collected between October 2013 and June 2016 by the Survey of Healthcare Experiences of Patients (SHEP). Our sample is comprised of 94,496 patients. We estimate logistic models with 1month lagged facility-level predictors. MAIN MEASURES: We calculate monthly measures characterizing facility-level service provision, including the average time between successive primary care visits, the average primary care visit length, the percentage of primary care appointments that are overbooked, the percent of visits that are unscheduled (i.e., walk-ins), and the ratio of patients to providers. We control for economic factors that are associated with health care supply and demand, including median household income, veteran priority status, the Zillow Housing Price Index, and veteran unemployment rates. We also control for patient demographics. PATIENTS: We restrict the data to patients with at least one in-person primary care visit who have provided information on their ability to access urgent and routine care. KEY RESULTS: We find that shorter average follow-up times are associated with better access for patients needing urgent or routine care. A 1-month increase in the average time between successive primary care visits is associated with 10% (p < 0.001) lower odds of reporting being able to access urgent care within 1 day and 13% (p < 0.001) lower odds of reporting usually or always being able to access routine care when needed. CONCLUSION: Facilities with higher average follow-up times are more likely to have patients report that they are unable to quickly access urgent or routine primary care.

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“…To determine pathogenicity, each HRR gene variant was reviewed in OncoKB, an online precision oncology knowledge database, in May 2021. 13 Apart from the NPOP database, the VA Corporate Data Warehouse, 14 a repository comprising data from VA clinical and administrative systems, and Joint Legacy Viewer, 15 which provides read-only access to all Veterans Health Administration electronic health records, were additional data sources.…”

Section: Data Source and Ethical Considerationsmentioning

confidence: 99%

Homologous Recombination Repair Gene Variants and Outcomes Among Patients With Prostate Cancer Treated With Poly (ADP-ribose) Polymerase Inhibitors

Price

Vashistha

Winski

et al. 2022

JCO Precision Oncology

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PURPOSE Poly ADP-ribose polymerase inhibitors (PARPi) are used for patients with advanced prostate cancer bearing alterations in homologous recombination repair (HRR) genes. We sought to characterize HRR gene variants and describe real-world outcomes for patients on PARPi. METHODS The US Department of Veterans Affairs’ National Precision Oncology Program’s database was reviewed to identify patients who underwent somatic DNA sequencing and were prescribed a PARPi before May 15, 2020. Somatic and germline variants within HRR genes were reported, and pathogenicity was reviewed via OncoKB. In patients treated with PARPi for > 4 weeks, the rate of those achieving a 30% decrease in prostate-specific antigen (PSA30) and composite progression-free survival (PFS) were compared between patients bearing pathogenic variants of BRCA2 and patients without these variants using Mann-Whitney and log-rank tests, respectively. RESULTS Forty-eight patients bearing 67 total HRR gene variants were prescribed PARPi for prostate cancer. Twenty-one patients (43.8%) were found to have at least one pathogenic HRR gene variant. Eight (16.6%) were referred to genetic counseling, and five (10.4%) were ultimately confirmed with germline variants. The median PFS was 4.0 months, and PSA30 was 25.6% (11 of 43) for all 43 evaluable patients. Patients with pathogenic BRCA2 variants (n = 13) had higher PSA30 (69.2% v 4.0%; P < .001) and longer PFS (7.2 v 2.8 months; P = .0291) than those without. CONCLUSION In a real-world setting, heavily pretreated patients with prostate cancer and pathogenic BRCA2 variants have a significant PSA response rate and a PFS > 7 months with PARPi. This work emphasizes the importance of determining pathogenicity and origin of HRR alterations to better inform clinical treatment decisions and highlights the need for provider education and other decision support tools.

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Effect on VA Patient Satisfaction of Provider’s Use of an Integrated Viewer of Multiple Electronic Health Records

Cited by 23 publications

References 9 publications

Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

The Relationship Between Follow-up Appointments and Access to Primary Care

Homologous Recombination Repair Gene Variants and Outcomes Among Patients With Prostate Cancer Treated With Poly (ADP-ribose) Polymerase Inhibitors

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