Learning From Primary Care EHR Exemplars About HIT Safety

 描述(由申请人提供)：为响应AHRQ特别强调通知(SEN NOT-HS-15-005)，并认识到需要关于安全健康信息技术(HIT)实践的新证据，拟议项目的目标是确定在初级保健中使用安全电子健康记录(EHR)的实用方法。这一问题在用于HIT的资源最少的小型初级保健实践中尤为突出。在这项申请中，我们建议在初级保健实践研究网络(PPRNet)的范例实践中进行这样的探索，PPRNet是AHRQ赞助的初级保健实践研究和学习中心。范例实践被定义为那些在广泛的临床质量衡量标准上取得高绩效的实践。该项目的目标是：1)对20个小样本做法的初级保健临床医生进行焦点小组访谈，以确定他们对HIT SAFER指南国家协调员办公室建议的做法的看法，他们对这些做法的采用，以及它们对电子健康记录安全的影响；2)与电子健康记录供应商专家进行关键线人访谈，以提供与安全HIT相关的战略的更多视角；以及，3)使用基于文字记录的定性分析，为在小型初级保健实践中安全使用电子健康记录制定实用的关键战略和最佳做法的分类。这项研究的发现应该有助于美国数以万计的小型初级保健实践防止因采用EHR而导致的患者安全问题。

 DESCRIPTION (provided by applicant): In response to AHRQ Special Emphasis Notice (SEN NOT-HS-15-005) and in recognition of the need for new evidence on safe health information technology (HIT) practices, the goal of the proposed project is to identify pragmatic approaches to safe electronic health record (EHR) use in primary care. This issue is particularly salient in small primary care practices with minimal resources devoted to HIT. In this application we propose such exploration among exemplar practices in the Primary Care Practices Research Network (PPRNet), an AHRQ-sponsored Center for Primary Care Practice-Based Research and Learning. Exemplar practices are defined as those achieving high performance on a broad set of clinical quality measures. The project aims to: 1) conduct focus group interviews with primary care clinicians from 20 small exemplar practices to identify their perspectives on recommended practices from the Office of the National Coordinator for HIT SAFER guides, their adoption of these practices, and their impact on EHR safety; 2) conduct key informant interviews with EHR vendor experts to provide additional perspectives on strategies associated with safe HIT; and, 3) use qualitative transcript- based analyses to develop a taxonomy of pragmatic key strategies and best practices for safe EHR use in small primary care practices. Findings from this study should help tens of thousands of small primary care practices in the United States prevent patient safety issues resulting from their adoption of EHRs.