Feedback and training tool to improve provision of preventive care
by physicians using EMRs: a randomised control trial

Maddocks, Heather; Stewart, Moira; Thind, Amardeep; Terry, Amanda; Chevendra, Vijaya; Marshall, Jonathan; Denomme, Louisa Bestard; Cejic, Sonny

doi:10.14236/jhi.v19i3.807

Cited by 7 publications

(9 citation statements)

References 6 publications

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“…EMR tools have been successful in assisting OB/GYN physicians in adherence to CCS guidelines transformation [ 29 ]. Since clinical data collection and use of data for population management in EMR systems are integral components of PCMH, it will be important to monitor its impact on improving the capacity of HCs primary care physicians to provide CCS and another preventive care [ 30 ]. Other common system-level solutions included changes in staffing such as either hiring new employees or increasing existing employees' hours as patient navigators, incorporating a quality improvement process, and implementing improved care management protocols [ 8 ].…”

Section: Resultsmentioning

confidence: 99%

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Moshkovich

Lebrun‐Harris

Makaroff

et al. 2015

Advances in Preventive Medicine

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Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS) persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs) have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH) transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen's Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs) and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

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Section: Resultsmentioning

confidence: 99%

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Moshkovich

Lebrun‐Harris

Makaroff

et al. 2015

Advances in Preventive Medicine

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“…The limited evidence on the effectiveness of training in improving data quality in EHRs indicates that short-term, low-intensity training has limited impact (Maddocks et al 2011). As for other areas of behaviour change and skills development, substantial improvements in data quality are likely to require more intensive training associated with other strategies that are specifically designed to overcome the barriers to improvement as relevant to local contexts (Kaplan et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Bailie

Chakraborty

et al. 2015

Aust. J. Prim. Health

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Abstract. The quality of data derived from primary healthcare electronic systems has been subjected to little critical systematic analysis, especially in relation to the purported benefits and substantial investment in electronic information systems in primary care. Many indicators of quality of care are based on numbers of certain types of patients as denominators. Consistency of denominator data is vital for comparison of indicators over time and between services. This paper examines the consistency of denominator data extracted from electronic health records (EHRs) for monitoring of access and quality of primary health care. Data collection and analysis were conducted as part of a prospective mixed-methods formative evaluation of the Commonwealth Government's Indigenous Chronic Disease Package. Twenty-six general practices and 14 Aboriginal Health Services (AHSs) located in all Australian States and Territories and in urban, regional and remote locations were purposively selected within geographically defined locations. Percentage change in reported number of regular patients in general practices ranged between -50% and 453% (average 37%). The corresponding figure for AHSs was 1% to 217% (average 31%). In approximately half of general practices and AHSs, the change was 20%. There were similarly large changes in reported numbers of patients with a diagnosis of diabetes or coronary heart disease (CHD), and Indigenous patients. Inconsistencies in reported numbers were due primarily to limited capability of staff in many general practices and AHSs to accurately enter, manage, and extract data from EHRs. The inconsistencies in data required for the calculation of many key indicators of access and quality of care places serious constraints on the meaningful use of data extracted from EHRs. There is a need for greater attention to quality of denominator data in order to realise the potential benefits of EHRs for patient care, service planning, improvement, and policy. We propose a quality improvement approach for enhancing data quality.Additional keywords: clinical information systems, electronic data extraction, primary health care, quality indicators, quality of data.

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“…Full-text screening was performed on the 19 retrieved studies. Twelve were identified that fit the previously specified inclusion criteria 23–34. The PreferredReporting Items for Systematic Reviews and Meta-Analyses flow chart was used to map out the study selection process as shown in figure 2.…”

Section: Resultsmentioning

confidence: 99%

Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis

Hamade

Terry

Malvankar-Mehta

2019

BMJ Health Care Inform

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BackgroundElectronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their proper use benefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of care; 3) reduced errors and 4) more involved patients. The use of EMRs is defined by practitioners using EMRs and their features to perform daily practice functions.ObjectiveThe purpose of this systematic review was to identify interventions aimed at improving EMR use in primary healthcare settings.MethodsTen online databases were searched to identify studies conducted in primary healthcare settings aimed at implementing interventions to observe the use of EMRs and directly measure the use of EMR functions or outcomes effected by the use of EMR functions.ResultsOf 2098 identified studies, 12 were included in the review. Results showed that interventions focused on the use of EMR functions, including referrals, electronic communication, reminders, use of clinical decision support systems and workflow management support functions, were five times more likely to show improvements in EMR use compared with controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared with controls.ConclusionsIndividuals in primary healthcare settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons such as clinical decision support systems and customised referral templates, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality.

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Feedback and training tool to improve provision of preventive care by physicians using EMRs: a randomised control trial

Cited by 7 publications

References 6 publications

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality

Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis

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