Synthesizing Lessons Learned Using Health Information Technology

综合利用健康信息技术获得的经验教训

• 批准号: 8044833
• 负责人: Lynne S. Nemeth
• 金额: $ 5.16万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8044833
• 关键词: Synthesizing; Lessons; Learned; Using; Health

DESCRIPTION (provided by applicant): During the past decade, Practice Partner Research Network (PPRNet) has established a theoretically-informed framework for translating research into practice (TRIP) within small to medium sized primary care practices that use the Practice Partner(R) (McKesson Corporation, Seattle, WA) electronic medical record (EMR). The PPRNet-TRIP Quality Improvement (QI) Model features three components: an intervention model, an improvement model and a practice development model that assists practices with implementation of quality improvement (QI). Using the PPRNet-TRIP QI Model this practice-based research network (PBRN) guided its' member practices to improve quality on a robust set of primary care measures. PPRNet-TRIP QI's intervention model is implemented in practice settings through a combination of performance reports, site visits, and network meetings. The improvement model focuses on prioritizing performance, involving all staff, redesigning the delivery system, patient activation, and using EMR tools. The practice development model helps practices understand and implement QI using seven concepts: leaders setting a vision with clear goals; involving the team; enhancing communication systems; developing the team; taking small steps; assimilating the EMR to maximize clinical effectiveness; and providing feedback within a culture of improvement, leading to an iterative cycle of goal setting by leaders. This proposed research addresses the use of health information technology (HIT) to improve health care decision-making by evaluating how quality of care is improved while using EMRs, and how to increase the adoption of new roles in practice settings to improve communication between patients and practices about health care. The specific aims of this two year project are to: 1) Complete a mixed methods secondary analysis to synthesize findings related to improving quality using HIT in primary care across seven nationally funded PPRNet initiatives. 2) Examine current perspectives of PPRNet-TRIP study practice participants related to: developing and sustaining QI efforts; and team development for an increasingly more active health care delivery role through robust EMR implementation. 3) Integrate findings from PPRNet's previous studies with the current perspectives of practice representatives to refine the overarching theory-based "PPRNet-TRIP QI Model". The aims and products of the proposed R03 will further the goals of supporting safe, efficient and effective health care for all Americans through use of HIT to improve performance in real world of primary care practices. PUBLIC HEALTH RELEVANCE: NARRATIVE - Coherent conceptual frameworks are needed to activate practices that aim to improve the delivery of primary care using their electronic medical records. The Practice Partner Research Network has used an internally developed conceptual framework for improving quality on a robust set of quality indicators. A systematic secondary analysis and synthesis of quality improvement sustainability and maintenance will provide evidence for refining the well-developed and useful PPRNet-TRIP QI model.

描述(由申请人提供)：在过去的十年中，实践伙伴研究网络(PPRNet)建立了一个理论上知情的框架，用于在使用Practice Partner(R)(McKesson Corporation，西雅图，华盛顿州)电子病历(EMR)的中小型初级保健实践中将研究转化为实践(TRIP)。PPRNet-Trip质量改进(QI)模型有三个组成部分：干预模型、改进模型和帮助实践实施质量改进(QI)的实践发展模型。使用PPRNet-Trip QI模型，这个以实践为基础的研究网络(PBRN)指导其成员实践在一套强有力的初级保健措施上提高质量。PPRNet-Trip QI的干预模式通过绩效报告、现场访问和网络会议的组合在实践环境中实施。改进模式的重点是确定绩效的优先顺序，让所有员工参与进来，重新设计交付系统，激活患者，并使用EMR工具。实践发展模式使用七个概念帮助实践者理解和实施QI：领导者制定具有明确目标的愿景；让团队参与进来；加强沟通系统；发展团队；采取小步骤；吸收EMR以最大限度地提高临床有效性；以及在改进的文化中提供反馈，导致领导者制定目标的迭代循环。这项拟议的研究旨在通过评估如何在使用EMR的同时提高护理质量，以及如何在实践环境中更多地采用新角色来改善患者与卫生保健实践之间的沟通，来使用卫生信息技术(HIT)来改善卫生保健决策。这个为期两年的项目的具体目标是：1)完成一项混合方法的二次分析，以综合在七个国家资助的PPRNet倡议中使用初级保健中的HIT来提高质量的结果。2)审查PPRNet-Trip研究实践参与者的当前前景，涉及以下方面：发展和持续的QI努力；以及通过强有力的EMR实施，为更积极的医疗保健提供角色的团队发展。3)将PPRNet以往的研究成果与实践代表的当前视角相结合，提炼出基于总体理论的PPRNet-Trip QI模型。建议的R03的目标和产品将通过使用HIT来提高初级保健实践的真实表现，从而进一步实现支持所有美国人安全、高效和有效的保健的目标。 公共卫生相关性：需要叙述连贯的概念框架，以启动旨在利用电子医疗记录改善初级保健提供的做法。业务伙伴研究网络使用了内部开发的概念框架，以便在一套健全的质量指标上提高质量。对质量改进、可持续性和维护进行系统的二次分析和综合，将为完善发展良好和有用的PPRNet-Trip QI模型提供证据。