Learning from Primary Care Meaningful Use Exemplars

Ornstein, Steven M.; Nemeth, Lynne S.; Nietert, Paul J.; Jenkins, Ruth G.; Wessell, Andrea M.; Litvin, Cara B.

doi:10.3122/jabfm.2015.03.140219

Cited by 7 publications

(9 citation statements)

References 30 publications

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“…Metrics for degree of use of specific functionalities were most often binary, distinguishing between use and nonuse of functions (n ¼ 15). Likert scales (e.g., "do not use," "use sometimes," "use all of the time") to determine use frequency were also used (n ¼ 7), 34,42,44,[48][49][50]54 and ranged from 3 to 5 points.…”

Section: Use Of Ehr Functionsmentioning

confidence: 99%

Measuring Electronic Health Record Use in Primary Care: A Scoping Review

Huang¹,

Gibson²,

Terry³

2018

Appl Clin Inform

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Section: Use Of Ehr Functionsmentioning

confidence: 99%

Measuring Electronic Health Record Use in Primary Care: A Scoping Review

Huang¹,

Gibson²,

Terry³

2018

Appl Clin Inform

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“…Through the study of meaningful use exemplars within a national network, Ornstein et al 12 remind us that it takes a team to effectively use HIT. Higher-quality performance was associated with staff education, use of standing orders, and care team reminders.…”

Section: It Takes a Teammentioning

confidence: 99%

Electronic Health Record Innovations for Healthier Patients and Happier Doctors

Krist

2015

The Journal of the American Board of Family Medicine

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This special issue explores a range of health information technology (HIT) issues that can help primary care practices and patients. Findings address the design of HIT systems, primarily electronic health records (EHRs), the utility of various functionalities, and implementation strategies that ensure the greatest value. The articles also remind us that, while HIT can support the delivery of care, it is not a panacea. To be effective, functionality needs to be relevant and timely for both the clinician and patient. Prompts and better documentation can improve care, and “prompt fatigue” is not inevitable. Information presented within EHRs needs to be actionable. There is an ongoing tension between information overload and the right—and helpful—information. Even the order of presentation of information can make a difference in the outcome. Whether supported by HIT or not, basic tenants of care, such as including the whole care team in trainings, communicating with other providers, and engaging patients, remain essential. The studies in this issue will prove useful for informatics developers, practices and health systems making HIT decisions, and care teams refining HIT to support the needs of their patients.

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“…5 However, CQMs by themselves do not illustrate which types of practices do well on specific quality metrics or what practices do to achieve higher performance as measured by CQMs. 6 In 2015, the Agency for Healthcare Research and Quality (AHRQ) funded seven regional cooperatives to help primary care practices implement evidence to improve healthcare, build practice capacity to receive and incorporate new evidence, learn how external quality improvement support helps primary care practices, and improve the way practices work to improve the health of their patients. 7 AHRQ was particularly interested in assessing and improving the delivery of cardiovascular care on four well-established guidelines: appropriate aspirin therapy, blood pressure control, cholesterol management, and smoking cessation.…”

Section: Introductionmentioning

confidence: 99%

“…12,13 Others have evaluated exemplary practices based on CQMs or colon cancer screening data using a single point in time. 6,14 The success of such pragmatic practice-based trials is often defined as the magnitude of improvement from baseline. In contrast, we sought to assess practice characteristics associated with CQM performance over time by including practices that both improved substantially or maintained high performance on CQMs.…”

Section: Introductionmentioning

confidence: 99%

Exemplary Practices in Cardiovascular Care: Results on Clinical Quality Measures from the EvidenceNOW Southwest Cooperative

et al. 2020

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BACKGROUND: Identifying characteristics of primary care practices that perform well on cardiovascular clinical quality measures (CQMs) may point to important practice improvement strategies. OBJECTIVE: To identify practice characteristics associated with high performance on four cardiovascular disease CQMs. DESIGN: Longitudinal cohort study among 211 primary care practices in Colorado and New Mexico. Quarterly CQM reports were obtained from 178 (84.4%) practices. There was 100% response rate for baseline practice characteristics and implementation tracking surveys. Followup implementation tracking surveys were completed for 80.6% of practices. PARTICIPANTS: Adult patients, staff, and clinicians in family medicine, general internal medicine, and mixedspecialty practices. INTERVENTION: Practices received 9 months of practice facilitation and health information technology support, plus biannual collaborative learning sessions. MAIN MEASURES: This study identified practice characteristics associated with overall highest performance using area under the curve (AUC) analysis on aspirin therapy, blood pressure management, and smoking cessation CQMs. RESULTS: Among 178 practices, 39 were exemplars. Exemplars were more likely to be a Federally Qualified Health Center (69.2% vs 35.3%, p = 0.0006), have an underserved designation (69.2% vs 45.3%, p = 0.0083), and have higher percentage of patients with Medicaid (p < 0.0001). Exemplars reported greater use of cardiovascular disease registries (61.5% vs 29.5%,), standing orders (38.5 vs 22.3%) or electronic health record prompts (84.6% vs 49.6%) (all p < 0.05), were more likely to have medical home recognition (74.4% vs 43.2%, p = 0.0006), and reported greater implementation of building blocks of high-performing primary care: regular quality improvement team meetings (3.0 vs 2.2), patient experience survey (3.1 vs 2.2), and resources for patients to manage their health (3.0 vs 2.3). High improvers (n = 45) showed greater improvement implementing team-based care (32.8 vs 11.7, p = 0.0004) and population management (37.4 vs 20.5, p = 0.0057). CONCLUSIONS: Multiple strategies-registries, prompts and protocols, patient self-management support, and patient-team partnership activities-were associated with delivering high-quality cardiovascular care over time, measured by CQMs.

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Learning from Primary Care Meaningful Use Exemplars

Cited by 7 publications

References 30 publications

Measuring Electronic Health Record Use in Primary Care: A Scoping Review

Measuring Electronic Health Record Use in Primary Care: A Scoping Review

Electronic Health Record Innovations for Healthier Patients and Happier Doctors

Exemplary Practices in Cardiovascular Care: Results on Clinical Quality Measures from the EvidenceNOW Southwest Cooperative

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