Geographic Variation in Ambulatory Electronic Health Record Adoption: Implications for Underserved Communities

King, Jennifer; Furukawa, Michael F.; Buntin, Melinda Beeuwkes

doi:10.1111/1475-6773.12078

Cited by 38 publications

(41 citation statements)

References 36 publications

(63 reference statements)

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“…Due to the nature of cross-sectional data and the inability to determine causality, endogeneity among some of the variables is a potential issue, and in the absence of an instrumental variable and longitudinal data, endogeneity becomes a limitation of our study. Since the SK&A data are self-reported by practices, there may be errors in reporting and data entry (King, Furukawa, & Buntin, 2013; Lynch et al, 2014). Individual practices that are solely associated with NPs and without physicians (e.g., nurse-managed health centers and retail clinics) are not represented.…”

Section: Discussionmentioning

confidence: 99%

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

et al. 2016

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Increasing patient demand following health care reform has led to concerns about provider shortages, particularly in primary care and for Medicaid patients. Nurse practitioners (NPs) represent a potential solution to meeting demand. However, varying state scope of practice regulations and Medicaid reimbursement rates may limit efficient distribution of NPs. Using a national sample of 252,657 ambulatory practices, we examined the effect of state policies on NP employment in primary care and practice Medicaid acceptance. NPs had 13% higher odds of working in primary care in states with full scope of practice; those odds increased to 20% if the state also reimbursed NPs at 100% of the physician Medicaid fee-for-service rate. Furthermore, in states with 100% Medicaid reimbursement, practices with NPs had 23% higher odds of accepting Medicaid than practices without NPs. Removing scope of practice restrictions and increasing Medicaid reimbursement may increase NP participation in primary care and practice Medicaid acceptance.

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Section: Discussionmentioning

confidence: 99%

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

et al. 2016

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“…21 Policies should focus interventions to assist health centers in high poverty areas and in states with relatively low EHR adoption rates. In addition, participation in initiatives such as the Health Center Controlled Network program should be encouraged to help health centers make the work-flow changes necessary to use health IT to improve clinical care.…”

mentioning

confidence: 99%

Adoption And Use Of Electronic Health Records Among Federally Qualified Health Centers Grew Substantially During 2010–12

Jones

Furukawa

2014

Health Affairs

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Federally qualified health centers play an important role in providing health care to underserved populations. Recent substantial federal investments in health information technology have enabled health centers to expand their use of electronic health record (EHR) systems, but factors associated with adoption are not clear. We examined 2010-12 administrative data from the Health Resources and Services Administration's Uniform Data System for more than 1,100 health centers. We found that in 2012 nine out of ten health centers had adopted a EHR system, and half had adopted EHRs with basic capabilities. Seven in ten health centers reported that their providers were receiving meaningful-use incentive payments from the Centers for Medicare and Medicaid Services (CMS). Only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements. Health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs. Policy initiatives should focus assistance on EHR capabilities with slower uptake; connect providers with technical assistance to support implementation; and leverage the connection between meaningful use and quality recognition programs.

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“…Research has shown there is variation in EHR adoption nationally [37,38]. Different rates of EHR system adoption among both inpatient and ambulatory healthcare organizations may be impacting the PHM use.…”

Section: Health-related Factorsmentioning

confidence: 99%

Assessment of Personal Health Care Management and Chronic Disease Prevalence: Comparative Analysis of Demographic, Socioeconomic, and Health-Related Variables (Preprint)

Sandefer¹,

Westra²,

Khairat³

et al. 2017

Preprint

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Geographic Variation in Ambulatory Electronic Health Record Adoption: Implications for Underserved Communities

Cited by 38 publications

References 36 publications

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

Effects of Regulation and Payment Policies on Nurse Practitioners’ Clinical Practices

Adoption And Use Of Electronic Health Records Among Federally Qualified Health Centers Grew Substantially During 2010–12

Assessment of Personal Health Care Management and Chronic Disease Prevalence: Comparative Analysis of Demographic, Socioeconomic, and Health-Related Variables (Preprint)

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