Impact of Meaningful Use Patient Engagement Objectives in a Multicultural PBRN

描述(由申请人提供)：德克萨斯州休斯敦的南方初级保健城市研究网络(SPUR-NET)是由AHRQ P30拨款资助的Prime-Net卓越研究和学习中心的参与成员。贝勒医学院的家庭和社区医学系(DFCM)是SPUR-NET的学术总部。许多支线网诊所已经实施了电子健康记录(EHR)，并开始参与2009年HITECH法案下的有意义使用(MU)倡议。DFCM SPUR-Net临床医生和研究人员将大量研究和实践转型努力集中在满足MU目标上，包括利用EHR来满足患者参与需求并在不同的患者亚群中实现预期结果。因此，我们准备好提供与三个阶段3 MU患者参与目标相关的经验证据和政策建议。该项目的目标是评估在初级保健环境中广泛实施的EHR(EpicCare)的患者参与功能的当前利用率，以便提供有助于选择阶段3 MU标准的数据 SGRP 205、206和207。针对使用相同EHR计划的支线诊所(EpicCare)，我们将实现以下具体目标：(1)描述：(A)现有EpicCare访问后摘要(AVS)样本的内容；(B)先前资助项目(AHRQ任务顺序#17)期间生成的AVS患者说明部分的内容；(B)AVS患者说明部分内容(包括特定诊断说明、患者教育材料和非英语语言材料)与患者报告结果之间的关系(SGRP 205和206)。(2)对使用EpicCare的初级保健提供者进行调查，了解他们与使用AVS患者说明部分相关的知识、态度和做法，包括使用(A)系统设计的“智能短语”；(B)由个人提供者或实践产生的“智能短语”；(C)非英语语言材料；以及(D)决定患者说明内容的决定的患者特征(SGRP 205和206)。(3)比较患者使用安全的Web门户(EpicCare EHR)来查看他们的医疗记录并在私人诊所与公共医疗机构进行沟通的情况，公共医疗机构为未参保和参保不足的主要少数族裔患者提供服务。目标3中要审查的变量包括：(A)首次访问后注册使用门户网站的新患者的比例；(B)首次访问门户网站后首次使用门户网站的时间；(C)在特定时间间隔内使用门户网站的频率；以及(D)发送的消息/请求的类型(SGRP207)；(4)使用传统方式传播研究结果，例如会议报告和在同行评议的期刊上发表的出版物以及信息技术渠道，包括通过适当的分发名单宣布的正式网络研讨会，并将结果张贴在支线网和优质网网站上。

DESCRIPTION (provided by applicant): The Southern Primary-Care Urban Research Network (SPUR-Net) in Houston, Texas, is a participating member of the PRIME-Net Center of Research Excellence and Learning funded by an AHRQ P30 grant. The Department of Family and Community Medicine (DFCM) at Baylor College of Medicine is the academic home of SPUR-Net. Many SPUR-Net clinics have implemented electronic health records (EHRs) and begun participating in the meaningful use (MU) initiative under the HITECH act of 2009. DFCM SPUR-Net clinicians and researchers have focused a number of research and practice transformation efforts on meeting MU objectives, including utilization EHRs to meet patient engagement requirements and achieve desired outcomes among diverse subgroups of patients. We are therefore well prepared to provide empirical evidence and policy suggestions related to three Stage 3 MU patient engagement objectives. The goal of the project is to evaluate current utilization of patient engagement features of an widely implemented EHR (EpicCare) in primary care settings in order to provide data that will be useful in selecting Stage 3 MU criteria for the SGRP 205, 206, and 207. Targeting SPUR-Net clinics that use the same EHR program (EpicCare), we will achieve the following Specific Aims: (1) Describe: (a) the content of an existing sample of EpicCare After Visit Summary (AVS) Patient Instructions Sections generated during a previously funded project (AHRQ Task Order #17); (b) the relationship between AVS Patient Instruction Section content, including diagnosis-specific instructions, patient education materials, and non-English language materials, plus patient-reported outcomes(SGRP 205 AND 206). (2) Survey SPUR-Net primary care providers who use EpicCare about their knowledge, attitudes, and practices related to using the AVS Patient Instructions Section, including use of (a) "smart phrases" designed by the system; (b) "smart phrases" produced by the individual provider or practice; (c) non-English language materials; and (d) and patient characteristics that determine decisions about the content of patient instructions (SGRP 205 and 206). (3) Compare patients' utilization of a secure Web portal (the EpicCare EHR) to view their medical records and communicate with providers in a private practice vs. a public health care setting that serves uninsured and under-insured, predominantly minority patients. Variables to be examined in Aim 3 include: (a) proportion of NEW patients who register to use the Web portal after their initial visit; (b) time to first use of the Web portal after the initial visit; (c) frequency of using the eb portal during a specified interval; and (d) types of messages/requests sent (SGRP 207); (4) Disseminate the study findings using traditional modes, such as conference presentations and publications in peer reviewed journals as well as information technology channels, including a formal Webinar announced via appropriate distribution lists, and posting the results on the SPUR-Net and PRIME-Net Websites.