Information system support as a critical success factor for chronic disease management: Necessary but not sufficient

Green, Carolyn J.; Fortin, P; Maclure, Malcolm; Macgregor, Art; Robinson, Sylvia

doi:10.1016/j.ijmedinf.2006.05.042

Cited by 68 publications

(49 citation statements)

References 8 publications

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“…Similar fi ndings in studies comparing chronic disease management in paper-based and electronic practices in the United States, 47 and Quebec 48 suggest that although practice information systems can assist chronic disease management, using such systems is no guarantee of effective chronic disease care.…”

Section: Discussionmentioning

confidence: 74%

Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

Russell¹,

Dahrouge²,

Hogg³

et al. 2009

The Annals of Family Medicine

157

143

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PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identifi ed which practice organizational factors were independently associated with high-quality care. METHODSWe undertook a cross-sectional survey with nested qualitative case studies (2 practices per model) in 137 randomly selected primary care practices from 4 delivery models in Ontario Canada: fee for service, capitation, blended payment, and community health centers (CHCs). Practice and clinician surveys were based on the Primary Care Assessment Tool. A chart audit assessed evidence-based care delivery for patients with diabetes, congestive heart failure, and coronary artery disease. Intermediate outcomes were calculated for patients with diabetes and hypertension. Multiple linear regression identifi ed those organizational factors independently associated with chronic disease management. RESULTSChronic disease management was superior in CHCs. Clinicians in CHCs found it easier than those in the other models to promote high-quality care through longer consultations and interprofessional collaboration. Across the whole sample and independent of model, high-quality chronic disease management was associated with the presence of a nurse-practitioner. It was also associated with lower patient-family physician ratios and when practices had 4 or fewer full-time-equivalent family physicians. CONCLUSIONSThe study adds to the literature supporting the value of nursepractitioners within primary care teams and validates the contributions of Ontario's CHCs. Our observation that quality of care decreased in larger, busier practices suggests that moves toward larger practices and greater patientphysician ratios may have unanticipated negative effects on processes of care quality. 2009;7:309-318. doi:10.1370/afm.982. Ann Fam Med INTRODUCTIONC hronic health conditions are a substantial challenge to global health.1 By 2020 they will account for 73% of all deaths and 60% of the global burden of disease.2-5 Canada's experience matches that of much of the developed world, where in the next decade deaths caused by chronic diseases will increase by 15%. 6 The growing burden of chronic diseases threatens the sustainability of health care systems. 7,8 In the United States, for example, the annual economic effect on the US economy of the most common chronic diseases is more than $1 trillion and could reach nearly $6 trillion by the middle of the century. 4 Canada stands to lose $9 billion in the next decade from premature deaths caused by heart disease, stroke, and diabetes. Policy makers have become increasingly interested in the potential of high-quality primary care to help deal with the chronic disease challenge. Primary care is well positioned to have an important impact on outcomes of care for patients with chronic conditions. 9 The...

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Section: Discussionmentioning

confidence: 74%

Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

Russell¹,

Dahrouge²,

Hogg³

et al. 2009

The Annals of Family Medicine

157

143

View full text Add to dashboard Cite

show abstract

“…In addi tion, a diverse sample was chosen to represent a range of characteristics in terms of the level of amputation, personality (those who were lively and outspoken and those who were silent in nature), minority ethnic groups (e.g. the coloured race) and socio economic status as described by Green et al, (2006). Participants were chosen from those, who when recruited for the larger study and gave informed consent to be part of the qualitative study too.…”

Section: Participantsmentioning

confidence: 99%

The impact of lower limb amputation on community reintegration of a population in Johannesburg: A Qualitative perspective

Godlwana¹,

Stewart²

2013

South African Journal of Physiotherapy

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“…Information technology including registry systems has multiple benefits especially for chronic diseases (36,37).…”

Section: Discussionmentioning

confidence: 99%

Enabling informed policymaking for chronic kidney disease with a registry: Initiatory steps in Iran and the path forward

Niazkhani

Cheshmekaboodi

Pirnejad

et al. 2018

Health Policy and Technology

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Enabling informed policymaking for chronic kidney disease with a registry: initiatory steps in Iran and the path forward, Health Policy and Technology, https://doi.org/10. 1016/j.hlpt.2018.01.004 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Chronic kidney disease (CKD) registries have been used for more than half a century. Iran lacks a comprehensive registry to capture data of all CKD patients for an informed care planning and policy making. We aimed to identify the objectives and possible challenges for developing a CKD registry and also to define its minimum data set (MDS)in our healthcare context. MethodsThis was a mixed-method study conducted in Iran from fall 2016 till summer 2017. The qualitative part included document analysis and 26 semi-structured interviews with 17 clinicians and managers involved in CKD care. This data was analyzed using the "grounded theory". Then, a modified Delphi survey was conducted. Percentages and mode values were used for analysis. ResultsOur participants' leading interest in a CKD registry was centered on providing a coordinated, qualitative care for all CKD stages with particular emphasis to capture events and monitor trends for patients in earlier stages. They highlighted the required financial, technical and human resources as main challenges for a smooth registry implementation. Furthermore, a clinically oriented MDS comprising of 168 elements (with a majority having more than 90% agreement with mode 2) was extracted. It mainly collects demographics, medical history, encounter sessions, diagnostic examinations, medications, vaccinations and mortality data. Conclusions 3We reported the initiatory steps taken to establish a CKD registry in an Iranian healthcare context. We focused on the information needs and priorities of our main stakeholders and based our intended registry on addressing those needs. We hope this approach will facilitate its endorsement and advance the efforts for a sustainable, qualitative CKD care.

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Information system support as a critical success factor for chronic disease management: Necessary but not sufficient

Cited by 68 publications

References 8 publications

Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors

The impact of lower limb amputation on community reintegration of a population in Johannesburg: A Qualitative perspective

Enabling informed policymaking for chronic kidney disease with a registry: Initiatory steps in Iran and the path forward

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