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Survey of Information Exchange and Advanced Use of Other Health Information Technology in Primary Care Settings: Capabilities In and Outside of the Safety Net.
Cross, Dori A; Stevens, Maria A; Spivack, Steven B; Murray, Genevra F; Rodriguez, Hector P; Lewis, Valerie A.
Afiliação
  • Cross DA; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN.
  • Stevens MA; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC.
  • Spivack SB; Center for Outcomes and Evaluation, Yale School of Medicine, New Haven, CT.
  • Murray GF; Department of General Internal Medicine, Boston Medical Center, Boston, MA.
  • Rodriguez HP; Department of Health Policy and Management, University of California-Berkeley School of Public Health, Berkeley, CA.
  • Lewis VA; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC.
Med Care ; 60(2): 140-148, 2022 02 01.
Article em En | MEDLINE | ID: mdl-35030563
BACKGROUND: Advanced use of health information technology (IT) functionalities can support more comprehensive, coordinated, and patient-centered primary care services. Safety net practices may benefit disproportionately from these investments, but it is unclear whether IT use in these settings has kept pace and what organizational factors are associated with varying use of these features. OBJECTIVE: The aim was to estimate advanced use of health IT use in safety net versus nonsafety net primary care practices. We explore domains of patient engagement, population health management (decision support and registries), and electronic information exchange. We examine organizational characteristics that may differentially predict advanced use of IT across these settings, with a focus on health system ownership and/or membership in an independent practice network as key factors that may indicate available incentives and resources to support these efforts. RESEARCH DESIGN: We conduct cross-sectional analysis of a national survey of physician practices (n=1776). We use logistic regression to predict advanced IT use in each of our domains based on safety net status and other organizational characteristics. We then use interaction models to assess whether ownership or network membership moderate the relationship between safety net status and advanced use of health IT. RESULTS: Health IT use was common across primary care practices, but advanced use of health IT functionalities ranged only from 30% to 50% use. Safety net settings have kept pace with adoption of features for patient engagement and population management, yet lag in information exchange capabilities compared with nonsafety net practices (odds ratio=0.52 for federally qualified health centers, P<0.001; odds ratio=0.66 for other safety net, P=0.03). However, when safety net practices are members of a health system or practice network, health IT capabilities are comparable to nonsafety net sites. CONCLUSIONS: All outpatient settings would benefit from improved electronic health record usability and implementation support that facilitates advanced use of health IT. Safety net practices, particularly those without other sources of centralized support, need targeted resources to maintain equitable access to information exchange capabilities.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Propriedade / Atenção Primária à Saúde / Troca de Informação em Saúde Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Med Care Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Propriedade / Atenção Primária à Saúde / Troca de Informação em Saúde Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Med Care Ano de publicação: 2022 Tipo de documento: Article