Care Coordination Enabled by Health IT: What Will It Take?

国家质量保证委员会(NCQA)，美国家庭医生学会 研究网络(法新社NRN)和纽约市卫生和精神卫生部门已经加入 这项提案旨在解决有关可行性、临床接受度和可测量性的关键政策问题 MU阶段3的目标。我们的长期目标是展示如何有意义地使用医疗信息技术做出贡献 为实现更好的护理、健康的人群和社区的国家质量战略目标，以及 负担得起的医疗服务。该项目将检验六项建议的可行性、可测量性和临床相关性。 与护理协调有关的第三阶段目标，包括对账和跟踪转诊、护理 过渡记录，并将信息用于患者参与和临床决策。我们的特定 目标1评估拟议的MU阶段3的技术可行性和临床接受性 不同实践环境中护理协调的目标，目标2，以确定组织和 区分EHR实施水平较高和较低的实践的背景因素 拟议的MU阶段3设想的护理协调的功能和临床工作流程 目标和目标3探讨衡量和报告执行情况的方法 建议的MU第三阶段目标。这项混合方法研究将包括对300种不同做法的调查。 为了了解EHR功能和临床工作流程中护理协调活动的当前实施情况， 采访了20家实施了护理协调工作流程(使用和不使用电子病历)的诊所 功能，以及在医疗保健方面采用卫生信息技术能力的10个实践的案例研究 与拟议目标相关的协调。我们将审查结果和技术 通过与EHR供应商小组一起审查提出的建议。我们将利用这个项目的成果来 为我们的联邦政府提供实现提议的MU目标的路线图，以及如何 在门诊护理环境中通过提供者衡量他们的成就。在这个为期12个月的项目结束时，我们 将制定并传播可能对拟议的MU进行修订的建议 第三阶段目标和拟议措施，2)对电子健康记录改革的建议 认证标准，以及3)成功工作流程的实例和有关障碍的信息 实施。除了给联邦政策制定者的报告外，我们还将开发传播材料 适合初级保健和专科实践，并通过NCQA的教育广泛传播 通过AAFP教育渠道，并与AHRQ合作，为提供者和健康计划提供方案。

The National Committee for Quality Assurance (NCQA), the American Academy of Family Physicians National Research Network (AAFP NRN), and New York City Department of Health and Mental Hygiene have joined in this proposal to address critical policy questions regarding the feasibility, clinical acceptance, and measurability of MU Stage 3 objectives. Our long-term goal is to demonstrate how meaningful use of health IT can contribute to achievement of the National Quality Strategy goals of better care, healthy people and communities, and affordable care. This project will examine the feasibility, measurability and clinical relevance of six proposed MU Stage 3 objectives related to care coordination, including reconciliation and tracking of referrals, care transition record, and use of information for patient engagement and clinical decision-making. Our specific aims are Aim 1 To assess the technical feasibility and clinical acceptance of the proposed MU Stage 3 objectives for care coordination in diverse practice settings, Aim 2 to identify organizational and contextual factors that distinguish practices with a higher versus lower level of implementation of EHR functionality and clinical workflows for care coordination envisioned by the proposed MU Stage 3 objectives, and Aim 3 to explore methods for measuring and reporting on implementation of the proposed MU Stage 3 Objectives. This mixed-methods study will include a survey of 300 diverse practices to understand current implementation of care coordination activities in EHR functionality and clinical workflows, interviews of 20 practices that have implemented care coordination workflows with and without EHR functionality, and case studies of 10 practices that have adopted health IT capabilities for aspects of care coordination that are relevant to with the proposed objectives. We will vet the results and technical recommendations through review with a panel of EHR vendors. We will use the results of this project to provide our federal government a roadmap to achievement of the proposed MU objectives and how to measure their achievement by providers in ambulatory care settings. At the end of this 12-month project, we will have developed and disseminated 1) recommendations for potential revisions to the proposed MU Stage 3 objectives and to the proposed measures, 2) recommendations for changes in EHR certification criteria, and 3) examples of successful workflows and information on barriers to implementation. In addition to a report for federal policymakers, we will develop dissemination materials appropriate for primary care and specialty practices and disseminate these widely through NCQA's educational programs for providers and health plans, through AAFP educational channels, and in collaboration with AHRQ.