Use of Electronic Health Record Systems by Office-Based Pediatricians

Lehmann, Christoph U.; O’Connor, Karen G.; Shorte, Vanessa; Johnson, Timothy D.

doi:10.1542/peds.2014-1115

Cited by 81 publications

(69 citation statements)

References 10 publications

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“…However, the personal and practice demographic characteristics of physicians in this study are similar to those of other recent studies of pediatricians and family physicians. [32][33][34] Third, the response rate raises the possibility of nonresponse bias, although a nonresponse bias analysis was reassuring within the limits of observable data from our sampling frame and survey responses. Fourth, we could not account for all public and private sector quality measurement and reporting activities that could be occurring in these states that might have influenced results.…”

Section: Discussionmentioning

confidence: 99%

Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting

Zickafoose

Ireys

Swinburn

et al. 2016

Academic Pediatrics

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Objectives-To assess primary care providers' experiences with and attitudes toward pediatricfocused quality reports and identify key associated physician/practice characteristics.Methods-We performed a cross-sectional survey of pediatricians and family physicians providing primary care to publicly insured children in three states (North Carolina, Ohio, Pennsylvania). The survey included questions about receipt of pediatric quality reports, use of reports for quality improvement (QI), and beliefs about the effectiveness of reports for QI. We used multivariable analyses to assess associations between responses and physician/practice characteristics, including exposure to federally funded demonstration projects aimed at increasing quality reporting to physicians serving publicly insured children. We supplemented these analyses with a thematic investigation of data from 46 interviews with physicians, practice staff, and state demonstration staff.Results-727 physicians responded to the survey (overall response rate: 45.2%). The majority of physicians were receiving quality reports related to pediatric care (79.8%, 95% confidence interval [CI] 77.2-82.4%) and believed that quality reports can be effective in helping guide quality improvement (70.5%, 95% CI 67.5-73.5%). Fewer used quality reports to guide QI efforts (32.5%, 95% CI 29.5-35.6%). There were no significant associations between demonstration exposure and experiences or attitudes. Interview data suggested physicians were receptive to quality reporting, but significant barriers remain to using such reports for QI, such as limited staff time or training in QI.Conclusion-While pediatric quality reporting is considered a promising strategy, in this study state efforts appeared insufficient to overcome the barriers to using reports to guide practice-based QI.

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Section: Discussionmentioning

confidence: 99%

Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting

Zickafoose

Ireys

Swinburn

et al. 2016

Academic Pediatrics

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“…In the past five years, the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 [8] resulted in a dramatic increase in EHR implementation and use in U.S. hospitals and physician offices [9], and in large quantities of electronic clinical information becoming available in electronic format, a very appealing prospect for clinical data reuse. Incentives also spurred adoption of EHRs by general practitioners in the U.K. [10] Recent initiatives such as EHR4CR, [11] the Clinical and Translational Science Awards (CTSA) [12], the Strategic Health IT Advanced Research Projects (SHARP) program [13], and the Electronic Medical Records and Genomics (eMERGE) consortium [14] further added to this opportunity, contributing to the surge in clinical data reuse projects and publications observed.…”

Section: Introductionmentioning

confidence: 99%

Clinical Data Reuse or Secondary Use: Current Status and Potential Future Progress

Meystre¹,

Lovis²,

Bürkle³

et al. 2017

Yearb Med Inform

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SummaryObjective: To perform a review of recent research in clinical data reuse or secondary use, and envision future advances in this field. Methods: The review is based on a large literature search in MEDLINE (through PubMed), conference proceedings, and the ACM Digital Library, focusing only on research published between 2005 and early 2016. Each selected publication was reviewed by the authors, and a structured analysis and summarization of its content was developed. Results: The initial search produced 359 publications, reduced after a manual examination of abstracts and full publications. The following aspects of clinical data reuse are discussed: motivations and challenges, privacy and ethical concerns, data integration and interoperability, data models and terminologies, unstructured data reuse, structured data mining, clinical practice and research integration, and examples of clinical data reuse (quality measurement and learning healthcare systems). Conclusion: Reuse of clinical data is a fast-growing field recognized as essential to realize the potentials for high quality healthcare, improved healthcare management, reduced healthcare costs, population health management, and effective clinical research.

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“…These are key elements of an approach that is now called precision medicine (7). Successes in oncology and other technological developments—the rapidly decreasing cost of whole-genome sequencing (8), improvements in informatics, and the widespread adoption of electronic health records (9–11)—have galvanized interest in applying various forms of big data, including genomics, to diseases such as diabetes (12). In this article, we discuss the application of genomics to diabetes, with a focus on some of the challenges involved in conducting genomics research in human populations and implementing findings in practice.…”

Section: Introductionmentioning

confidence: 99%

The Application of Genomics in Diabetes: Barriers to Discovery and Implementation

Floyd

Psaty

2016

Diabetes Care

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The emerging availability of genomic and electronic health data in large populations is a powerful tool for research that has drawn interest in bringing precision medicine to diabetes. In this article, we discuss the potential application of genomics to the prediction, prevention, and treatment of diabetes, and we use examples from other areas of medicine to illustrate some of the challenges involved in conducting genomics research in human populations and implementing findings in practice. At this time, a major barrier to the application of genomics in diabetes care is the lack of actionable genomic findings. Whether genomic information should be used in clinical practice requires a framework for evaluating the validity and clinical utility of this approach, an improved integration of genomic data into electronic health records, and the clinical decision support and educational resources for clinicians to use these data. Efforts to identify optimal approaches in all of these domains are in progress and may help to bring diabetes into the era of genomic medicine.

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Use of Electronic Health Record Systems by Office-Based Pediatricians

Abstract: BACKGROUND AND OBJECTIVES: The American Recovery and Reinvestment Act of 2009 accelerated the implementation of electronic health records (EHRs) in pediatric offices. We sought to determine the prevalence and functionalities of EHRs, as well as pediatricians' perceptions of EHRs.

Cited by 81 publications

References 10 publications

Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting

Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting

Clinical Data Reuse or Secondary Use: Current Status and Potential Future Progress

The Application of Genomics in Diabetes: Barriers to Discovery and Implementation

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