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: 7875473
• 负责人: Lynne S. Nemeth
• 金额: $ 4.83万
• 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 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7875473
• 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）已经建立了一个理论上知情的框架，用于在使用实践伙伴（R）（McKesson Corporation，西雅图，WA）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）模型由三个部分组成：干预模型，改进模型和实践发展模型，帮助实践实施质量改进（QI）。使用PPRNet-TRIP QI模型，这个基于实践的研究网络（PBRN）指导其成员实践，以提高一套强大的初级保健措施的质量。PPRNet-TRIP QI的干预模型通过性能报告、现场访问和网络会议的组合在实践环境中实施。改进模型的重点是优先考虑性能，涉及所有工作人员，重新设计交付系统，患者激活，并使用EMR工具。实践开发模型使用七个概念帮助实践理解和实施QI：领导者设定具有明确目标的愿景;参与团队;增强沟通系统;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;并在改进文化中提供反馈，导致领导者设定目标的迭代周期。这项拟议的研究解决了使用卫生信息技术（HIT），以改善医疗保健决策，通过评估如何提高护理质量，同时使用EMR，以及如何增加在实践环境中采用新的角色，以改善患者和医疗保健实践之间的沟通。这一为期两年的项目的具体目标是：1）完成混合方法的二次分析，以综合与在七个国家资助的PPRNet倡议的初级保健中使用HIT提高质量有关的调查结果。2)检查PPRNet-TRIP研究实践参与者的当前观点，涉及：发展和维持QI工作;通过强大的EMR实施，团队发展越来越积极的医疗保健提供角色。3)将PPRNet以前的研究结果与实践代表的当前观点相结合，以完善基于总体理论的“PPRNet-TRIP QI模型”。拟议的R 03的目标和产品将通过使用HIT来提高真实的世界初级保健实践的绩效，进一步实现为所有美国人提供安全、高效和有效的医疗保健的目标。 公共卫生关系：叙述性-需要一致的概念框架来激活旨在使用电子病历改善初级保健提供的实践。业务伙伴研究网络采用了内部制定的概念框架，根据一套强有力的质量指标提高质量。系统的二次分析和质量改进的可持续性和维护的综合将提供证据，完善发达和有用的PPRNet-TRIP QI模型。