Reducing Overuse in Primary Care through Safe and Effective Health Information Technology

 描述（申请人提供）：为了响应AHRQ的研究项目的要求，使“医疗保健更安全的门诊护理设置和长期护理设施”（RFA-HS-15-002），这个拟议的项目的目标是使初级保健更安全的战略，以改善两个高优先级的安全问题，过度使用低价值的服务和更安全地使用健康信息技术（HIT）的新证据。过度使用低价值的服务，可能会导致严重的病人伤害是常见的，在初级保健设置，研究干预措施，以减少过度使用是有限的。在初级保健中安全HIT实践的证据也很有限。此外，HIT被认为是改善测量和减少过度使用的一种手段，但很少有研究探索这些潜力。拟议的项目旨在研究这些潜力，通过开发电子临床质量措施过度使用，整合两个成功的模式，增加提供建议的预防服务和安全的HIT使用，并测试这种综合模式的影响过度使用预防服务的初级保健实践中的两年组随机对照试验。该项目将在初级保健实践研究网络（PPRNet）进行，这是一个由AHRQ赞助的初级保健实践研究和学习中心。将采用定量和定性分析相结合的混合方法评估综合框架对过度使用的影响。该项目的研究结果将为在初级保健环境中安全有效地使用HIT以减少过度使用并提高患者安全性的策略提供新的证据。结果将适用于成千上万的初级保健提供者谁采用了电子健康档案在美国。

 DESCRIPTION (provided by applicant): In response to AHRQ's request for research projects to make "health care safer in ambulatory care settings and long term care facilities" (RFA-HS-15-002), the goal of this proposed project is to make primary care safer by generating new evidence on strategies to improve two high priority safety problems-overuse of low-value services and safer use of health information technology (HIT). Overuse of low-value services which may cause serious patient harms is common in the primary care setting, and research on interventions to reduce overuse is limited. Evidence is also limited on safe HIT practices in primary care. Moreover, HIT has been cited as a means to both improve the measurement of and reduce overuse, yet few studies have explored these potentials. The proposed project seeks to examine these potentials through developing electronic clinical quality measures for overuse, integrating two successful models for increasing delivery of recommended preventive services and safe HIT use, and testing the impact of this integrated model on overuse of preventive services in primary care practices in a two year group randomized controlled trial. The project will be conducted in the Primary Care Practices Research Network (PPRNet), an AHRQ-sponsored Center for Primary Care Practice- Based Research and Learning. A mixed methods approach, combining both quantitative and qualitative analyses, will be used to assess the impact of the integrated framework on overuse. The findings from this project will lead to new evidence on strategies for using HIT safely and effectively in the primary care setting to reduce overuse and improve patient safety. The results will be applicable to the tens of thousands of primary care providers who have adopted EHRs in the United States.