Meaningful Use of the Indian Health Service Electronic Health Record

Kruse, Matthew; Hays, Meredith; Orav, E. John; Palan, Martha; Sequist, M.P.H. Thomas D.

doi:10.1111/1475-6773.12531

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…Beginning in 2004, federally operated IHS facilities began implementing a single EHR, Resource and Patient Management System (RPMS), that was developed for IHS with end-user input and major contributions for shared core applications from the Department of Veterans Affairs legacy EHR, Veterans Health Information Systems and Technology Architecture (VistA) [71,72]. RPMS has been used across the United States by all facilities operated directly by IHS and most tribal and urban American Indian/Alaska Native health care programs [73,74]. IHS maintains a national library of electronic clinical reminders (ECR) that can be modified for local taxonomy and code [36].…”

Section: Discussionmentioning

confidence: 99%

Electronic Health Record-Integrated Clinical Decision Support for Clinicians Serving Populations Facing Health Care Disparities: Literature Review

et al. 2022

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Objectives: To review current studies about designing and implementing clinician-facing clinical decision support (CDS) integrated or interoperable with an electronic health record (EHR) to improve health care for populations facing disparities. Methods: We searched PubMed to identify studies published between January 1, 2011 and October 22, 2021 about clinician-facing CDS integrated or interoperable with an EHR. We screened abstracts and titles and extracted study data from articles using a protocol developed by team consensus. Extracted data included patient population characteristics, clinical specialty, setting, EHR, clinical problem, CDS type, reported user-centered design, implementation strategies, and outcomes. Results: There were 28 studies (36 articles) included. Most studies were performed at safety net institutions (14 studies) or Indian Health Service sites (6 studies). CDS tools were implemented in primary care outpatient settings in 24 studies (86%) for screening or treatment. CDS included point-of-care alerts (93%), order facilitators (46%), workflow support (39%), relevant information display (36%), expert systems (11%), and medication dosing support (7%). Successful outcomes were reported in 19 of 26 studies that reported outcomes (73%). User-centered design was reported during CDS planning (39%), development (32%), and implementation phase (25%). Most frequent implementation strategies were education (89%) and consensus facilitation (50%). Conclusions: CDS tools may improve health equity and outcomes for patients who face disparities. The present review underscores the need for high-quality analyses of CDS-associated health outcomes, reporting of user-centered design and implementation strategies used in low-resource settings, and methods to disseminate CDS created to improve health equity.

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Section: Discussionmentioning

confidence: 99%

Electronic Health Record-Integrated Clinical Decision Support for Clinicians Serving Populations Facing Health Care Disparities: Literature Review

et al. 2022

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“…Elements of the implementation experience include buy-in among leadership and staff, a description of how interventions were adapted and delivered, the role of community health workers, and strategies to address health equity. Clinical partners were also asked to discuss how quality of care initiatives impacted implementation of the PWTF interventions ( 40 ). All five CFIR domains were explored in this phase for each target health condition ( 21 ).…”

Section: Methodsmentioning

confidence: 99%

A Mixed Methods Approach to Evaluate Partnerships and Implementation of the Massachusetts Prevention and Wellness Trust Fund

Lee

Ramanadhan

Kruse

et al. 2018

Front. Public Health

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Background: Strong partnerships are critical to integrate evidence-based prevention interventions within clinical and community-based settings, offering multilevel and sustainable solutions to complex health issues. As part of Massachusetts' 2012 health reform, The Prevention and Wellness Trust Fund (PWTF) funded nine local partnerships throughout the state to address hypertension, pediatric asthma, falls among older adults, and tobacco use. The initiative was designed to improve health outcomes through prevention and disease management strategies and reduce healthcare costs.Purpose: Describe the mixed-methods study design for investigating PWTF implementation.Methods: The Consolidated Framework for Implementation Research guided the development of this evaluation. First, the study team conducted semi-structured qualitative interviews with leaders from each of nine partnerships to document partnership development and function, intervention adaptation and delivery, and the influence of contextual factors on implementation. The interview findings were used to develop a quantitative survey to assess the implementation experiences of 172 staff from clinical and community-based settings and a social network analysis to assess changes in the relationships among 72 PWTF partner organizations. The quantitative survey data on ratings of perceived implementation success were used to purposively select 24 staff for interviews to explore the most successful experiences of implementing evidence-based interventions for each of the four conditions.Conclusions: This mixed-methods approach for evaluation of implementation of evidence-based prevention interventions by PWTF partnerships can help decision-makers set future priorities for implementing and assessing clinical-community partnerships focused on prevention.

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“…The implementation of health information technology (HIT) in general and, in particular, of electronic health records (EHRs) in healthcare settings has many benefits. It is claimed that it can enhance the quality of patient care, 1 improve the coordination of medical care, 2 reduce medical errors, 3 and increase compliance with guidelines 4 . Primary healthcare settings are a critical part of healthcare, 5 and efforts are increasing to maximize the adoption of EHRs in these settings, 6 since they are patients' first point of contact with the healthcare system and play a key role in disease prevention and treatment 2 …”

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confidence: 99%

The Adoption of Electronic Health Records in Primary Healthcare Settings

Tubaishat

2021

CIN: Computers, Informatics, Nursing

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Little is known about the adoption rate of electronic health records in primary healthcare settings. This study aimed to estimate this adoption rate in Jordan, using a national survey with a descriptive cross-sectional design. The first step was to review the annual report of the Jordanian Ministry of Health as a basis for identifying the sample, which are primary healthcare settings. Then, Electronic Health Solutions, the company that vends electronic health record systems in Jordan, was used to determine which primary healthcare settings were using these electronic record systems. The final task was to determine which functionalities of the system were being used in these settings, and for this, a telephone survey of key personnel was conducted. It was found that 21.6% of the primary healthcare settings were using electronic health records, while the other 78.4% were still relying on paper records. The results also showed that the adoption rate of electronic health records was significantly associated with the type of the setting (P < .001), its size (P < .001), location (P < .001), and region (P = .04). As a conclusion, the adoption rate in Jordan is still in its infancy compared with those in developed countries. Policy and decision makers should therefore be focused on minimizing any challenges or obstacles to such adoption.

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Meaningful Use of the Indian Health Service Electronic Health Record

Abstract: Significant opportunities exist to increase use of EHR functionalities and preserve physician-patient interactions and productivity in a resource-limited environment.

Cited by 7 publications

References 29 publications

Electronic Health Record-Integrated Clinical Decision Support for Clinicians Serving Populations Facing Health Care Disparities: Literature Review

Electronic Health Record-Integrated Clinical Decision Support for Clinicians Serving Populations Facing Health Care Disparities: Literature Review

A Mixed Methods Approach to Evaluate Partnerships and Implementation of the Massachusetts Prevention and Wellness Trust Fund

The Adoption of Electronic Health Records in Primary Healthcare Settings

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