The Next Step Towards Making Use Meaningful

Abstract

Background Care for patients with chronic conditions often requires coordination between multiple physicians and delivery sites. Electronic Health Record (EHR) use could improve care quality and efficiency in part by facilitating care coordination. Objectives We examined the association between EHR use and clinician perceptions of care coordination for patients transferred across clinicians and delivery sites. Research Design Repeated surveys of primary care clinicians during the staggered implementation of an outpatient EHR (2005-2008), followed by an integrated inpatient EHR (2006-2010). We measured the association between EHR use stages (no use, outpatient EHR only, and integrated inpatient-outpatient EHR) and care coordination using logistic regression, adjusting for clinician characteristics, study year, and medical center. Subjects Adult primary care clinicians in a large integrated delivery system. Measures Three measures of clinician-reported care coordination for patient care transferred across clinicians (e.g., from specialist to primary care team) and across delivery sites (e.g., from the hospital to outpatient care). Results Outpatient EHR use was associated with higher reports of access to complete and timely clinical information and higher agreement on clinician roles and responsibilities for patients transferred across clinicians, but not for patients transferred across delivery sites. Use of the integrated outpatient-inpatient EHR was associated with higher reports of access to timely and complete clinical information, clinician agreement on the patient's treatment plan for patients transferred across delivery sites, and with all coordination measures for patients transferred across clinicians. Conclusions Use of an integrated EHR with health information exchange across delivery settings improved patient care coordination.

Data Content and Exchange in General Practice: a Review

“…The most prevalent application of the information exchange was for clinical use cases ( 3 , 11 , 13 , 16 , 17 , 21 , 23 ). This is in line with the importance of clinical communication for general practice ( 31 , 32 ) and it is in accordance with the fact that exchange of clinical data among health care professionals improves coordination of patient care through the continuum of health care ( 33 ). Due to importance of this information exchange, use of hyper links to various information sources in electronic patient records has been suggested as a solution for better communication of different clinical data between primary and secondary care ( 34 ).…”

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

“…We found 17 instruments that measure continuity of transitional care across the care continuum. Most tools (n = 14) were developed for community/primary care settings [2829303132333435363738394041], one was developed in acute care [42], and two in both, primary and acute care [4344]. The Care Transitions Measure (CTM, [43]) has a number of modifications [4546].…”

Utility and Perceived Value of a Provincial Digital Diagnostic Imaging Repository: Multimethod Study

“…The ability to electronically share patient-level information across institutional and geographic boundaries can facilitate an integrated and coordinated model of health care delivery among hospital-based and community-based health care professionals by providing timely transfer of relevant and complete information to inform clinical decision making [ 1 ]. Within the diagnostic imaging landscape, rapid and comprehensive sharing of imaging data has demonstrated multiple benefits at the patient, clinician, and health care system levels.…”