The Next Step Towards Making Use Meaningful

Electronic Information Exchange and Care Coordination Across Clinicians and Delivery Sites

Datos Bibliográficos

ID9100726
AutoresIlana Graetz (0000-0003-3664-5815, University of Tennessee Health Science Center, autor de correspondencia), Mary Reed (0000-0002-9986-9499, Kaiser Permanente, autor de correspondencia), Stephen M Shortell (0000-0002-7392-9801), Thomas G Rundall, Jim Bellows (Kaiser Permanente), John Hsu (0000-0001-8244-231X, MGH Institute of Health Professions)
Año2014
Volumen52
Número12
Páginas1037-1041
Fecha de publicación2014-12-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000245
PMID25304020
OpenAlexW2025414408
IdiomaEN
Citas recibidas5
Referencias citadas13

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. OBJECTIVE: 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 (eg, from specialist to primary care team) and across delivery sites (eg, 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. CONCLUSION: Use of an integrated EHR with health information exchange across delivery settings improved patient care coordination

Ambulatory care · Electronic health record · Family medicine · Health care · Health information · Health information exchange · Medical emergency · Medical record · Electronic Health Records Systems · Healthcare Systems and Technology · Medicine · Primary Care and Health Outcomes