Achieving Meaningful Use of Electronic Health Records (EHRs) in Primary Care: Proposed Critical Processes from the Kentucky Ambulatory Network (KAN)

Abstract

Objective: The Kentucky Ambulatory Network, a practice-based research network, conducted this study to propose critical processes for electronic health record (EHR) implementation.Methods: Periodic observation of the implementation process and assessment of meaningful use (MU) metrics within 10 small primary care practices working with a regional extension center.Results: Through focus groups and structured interviews, the strategies, processes, and procedures used by these practices to achieve MU of EHRs were determined. Implementation themes related to and critical processes associated with EHR adoption were proposed.Conclusions: Five proposed critical processes for EHR adoption and achievement of MU were identified; these processes were supported by 70% (7 of 10) of the study practices meeting MU criteria. (J Am Board Fam Med 2014;27:772-779.)

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

“…Five studies used electronic data extraction or reporting. [45][46][47]53,63 Electronic reporting includes the analysis of Meaningful Use attestation reports, which were required as of 2011 in the United States. Qualitative data collection methods, including in-person interviews (n ¼ 8), 22,33,37,52,55,56,60,61 and onsite observation (n ¼ 5), 33,37,41,52,55 were used less often.…”

“…Ten studies did not specify a setting, but included primary care physicians or practices in their analyses. Some specified a particular category of health organization, such as patientcentered medical homes (n ¼ 2), 31,46 small-to mediumsized practices (n ¼ 4), 33,40,45,56 and rural primary care practices (n ¼ 2). 22,54 The perspectives of the studies reviewed varied in whether they measured EHR use at the level of the practice/clinic (n ¼ 16) or at the level of the individual physician (n ¼ 15).…”

Public Health Investment in Team Care: Increasing Access to Clinical Preventive Services in Los Angeles County

“…Evidence suggests that teamwork, care coordination, and continuity are key elements for improving the quality and efficiency of primary care delivery, including CPS delivery ( 5 , 13 , 14 ). In recent years, several local health-care organizations [e.g., LAC Department of Health Services (DHS)] have moved toward a team care approach for delivery of these services.…”

“…Emphasis is placed on coordinating access to services across the broader health care system, making the experience more meaningful and efficient. Effective implementation of team care typically requires adoption and integration at multiple levels of the health care system, requiring support tools such as disease registries, electronic health records, decision support, provider reminder systems, and trainings to work in a team environment ( 4 , 13 ). In LAC, health organizations that serve priority populations are at initial stages of this system-level transformation.…”

Practice-based Research Networks at the Crossroads of Research Translation

“…PBRNs could further refine PRE-CIS to include these and other measures important for the bidirectional exchange between research and practice. 6 ) presents 8 themes, derived from qualitative research, of best practices for achieving "meaningful use" in primary care practices working with a regional extension center. These practical recommendations add to the rapidly growing evidence on effective EHR implementation.…”