Pediatricians’ Use of Health Information Technology: A National Survey

Leu, Michael G.; O’Connor, Karen G.; Marshall, Rebecca; Price, David T.; Klein, Jonathan D.

doi:10.1542/peds.2012-0396

Cited by 54 publications

(46 citation statements)

References 8 publications

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“…Barriers related to health information technology were largely not addressed in the studies reviewed, likely because the use of electronic health records in the primary-care setting over the past decade has increased significantly. 49,50 Recent interventions aimed at improving the integration of genetics medicine into primary care have demonstrated significant barriers toward collecting and updating FH information in electronic health records. Patient-entered FH data, including the use of electronic risk assessment models, has been demonstrated to reduce the time required by healthcare professionals to collect information and has not resulted in poorer quality of data.…”

Section: Discussionmentioning

confidence: 99%

Primary-care providers’ perceived barriers to integration of genetics services: a systematic review of the literature

Mikat-Stevens

Larson

Tarini

2015

Genetics in Medicine

208

216

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Purpose: We aimed to systematically review the literature to identify primary-care providers' perceived barriers against provision of genetics services. Methods:We systematically searched PubMed and ERIC using key and Boolean term combinations for articles published from 2001 to 2012 that met inclusion/exclusion criteria. Specific barriers were identified and aggregated into categories based on topic similarity. These categories were then grouped into themes.Results: Of the 4,174 citations identified by the search, 38 publications met inclusion criteria. There were 311 unique barriers that were classified into 38 categories across 4 themes: knowledge and skills; ethical, legal, and social implications; health-care systems; and scientific evidence. Barriers most frequently mentioned by primary-care providers included a lack of knowledge about genetics and genetic risk assessment, concern for patient anxiety, a lack of access to genetics, and a lack of time. Conclusion:Although studies reported that primary-care providers perceive genetics as being important, barriers to the integration of genetics medicine into routine patient care were identified. The promotion of practical guidelines, point-of-care risk assessment tools, tailored educational tools, and other systems-level strategies will assist primary-care providers in providing genetics services for their patients.

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Section: Discussionmentioning

confidence: 99%

Primary-care providers’ perceived barriers to integration of genetics services: a systematic review of the literature

Mikat-Stevens

Larson

Tarini

2015

Genetics in Medicine

208

216

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“…A 2009 study of EHR adoption in pediatric ambulatory settings demonstrated that needed functions (weight-based dosing, anthropometric analysis, immunization forecasting) were missing in ambulatory EHRs. 1 The lack of pediatric specific content 2 and functionality as delineated in the Model Pediatric EHR Format by the Agency for Healthcare Quality and Research 3 remains a barrier to implementation and use of EHRs.…”

Section: What This Study Addsmentioning

confidence: 99%

“…From 2009, the percentage of pediatricians who had neither basic nor fully functional EHRs (equivalent to none or any EHR) dropped significantly from 75.2% to 55%. 1,10 Among those with "fully functional" EHRs, 8% compared with 3% in 2009 (P , .001) reported 5 additional "pediatric-supportive" features (weight-based dosing, tracking recommended well-child visits and immunizations, calculating catch-up immunizations, and plotting growth charts and computing BMI). …”

Section: Figurementioning

confidence: 99%

Use of Electronic Health Record Systems by Office-Based Pediatricians

et al. 2015

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“…[5][6][7][8][9] Improving the capacity of primary care practices to meet national standards based on evidence-based quality metrics is central to emerging health care models, but significant hurdles exist. [10][11][12][13][14][15][16][17] System change is challenging; small group practices, the most common care setting, 13,[18][19][20] traditionally lack the systems, resources, and quality improvement experience needed to achieve broad-based, sustainable practice improvements. Practices differ in organization, leadership, and preferences, so 1 approach does not fit all, 21,22 and addressing 1 component at a time can be inefficient and counterproductive.…”

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confidence: 99%

Practice-Tailored Facilitation to Improve Pediatric Preventive Care Delivery: A Randomized Trial

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Children receive only half of recommended health care; disadvantaged children have higher risk of unmet needs. Practice coaching combined with quality improvement using rapid-cycle feedback has potential to help practices meet quality standards and improve pediatric health care delivery. WHAT THIS STUDY ADDS:The Practice-tailored Facilitation Intervention led to large and sustained improvements in preventive service delivery, including substantial numbers of disadvantaged children, and in multiple simultaneous health care domains. Practice-tailored facilitation holds promise as a method to advance pediatric preventive care delivery. abstract OBJECTIVE: Evolving primary care models require methods to help practices achieve quality standards. This study assessed the effectiveness of a Practice-Tailored Facilitation Intervention for improving delivery of 3 pediatric preventive services. METHODS:In this cluster-randomized trial, a practice facilitator implemented practice-tailored rapid-cycle feedback/change strategies for improving obesity screening/counseling, lead screening, and dental fluoride varnish application. Thirty practices were randomized to Early or Late Intervention, and outcomes assessed for 16 419 well-child visits. A multidisciplinary team characterized facilitation processes by using comparative case study methods. RESULTS:Baseline performance was as follows: for Obesity: 3.5% successful performance in Early and 6.3% in Late practices, P = .74; Lead: 62.2% and 77.8% success, respectively, P = .11; and Fluoride: ,0.1% success for all practices. Four months after randomization, performance rose in Early practices, to 82.8% for Obesity, 86.3% for Lead, and 89.1% for Fluoride, all P , .001 for improvement compared with Late practices' control time. During the full 6-month intervention, care improved versus baseline in all practices, for Obesity for Early practices to 86.5%, and for Late practices 88.9%; for Lead for Early practices to 87.5% and Late practices 94.5%; and for Fluoride, for Early practices to 78.9% and Late practices 81.9%, all P , .001 compared with baseline. Improvements were sustained 2 months after intervention. Successful facilitation involved multidisciplinary support, rapid-cycle problem solving feedback, and ongoing relationship-building, allowing individualizing facilitation approach and intensity based on 3 levels of practice need.CONCLUSIONS: Practice-tailored Facilitation Intervention can lead to substantial, simultaneous, and sustained improvements in 3 domains, and holds promise as a broad-based method to advance pediatric preventive care.

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Pediatricians’ Use of Health Information Technology: A National Survey

Cited by 54 publications

References 8 publications

Primary-care providers’ perceived barriers to integration of genetics services: a systematic review of the literature

Primary-care providers’ perceived barriers to integration of genetics services: a systematic review of the literature

Use of Electronic Health Record Systems by Office-Based Pediatricians

Practice-Tailored Facilitation to Improve Pediatric Preventive Care Delivery: A Randomized Trial

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