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01.11.2011 | Perspectives

Defining Core Issues in Utilizing Information Technology to Improve Access: Evaluation and Research Agenda

verfasst von: George L. Jackson, PhD, MHA, Sarah L. Krein, PhD, RN, Dale C. Alverson, MD, Adam W. Darkins, MD, MPH, William Gunnar, MD, JD, Nancy D. Harada, PhD, PT, Christian D. Helfrich, PhD, MPH, Thomas K. Houston, MD, MPH, Thomas F. Klobucar, PhD, Kim M. Nazi, PhD, Ronald K. Poropatich, MD, James D. Ralston, MD, MPH, Hayden B. Bosworth, PhD

Erschienen in: Journal of General Internal Medicine | Sonderheft 2/2011

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Abstract

The Department of Veterans Affairs (VA) has been at the vanguard of information technology (IT) and use of comprehensive electronic health records. Despite the widespread use of health IT in the VA, there are still a variety of key questions that need to be answered in order to maximize the utility of IT to improve patient access to quality services. This paper summarizes the potential of IT to enhance healthcare access, key gaps in current evidence linking IT and access, and methodologic challenges for related research. We also highlight four key issues to be addressed when implementing and evaluating the impact of IT interventions on improving access to quality care: 1) Understanding broader needs/perceptions of the Veteran population and their caregivers regarding use of IT to access healthcare services and related information. 2) Understanding individual provider/clinician needs/perceptions regarding use of IT for patient access to healthcare. 3) System/Organizational issues within the VA and other organizations related to the use of IT to improve access. 4) IT integration and information flow with non-VA entities. While the VA is used as an example, the issues are salient for healthcare systems that are beginning to take advantage of IT solutions.

Brown SH, Lincoln MJ, Groen PJ, Kolodner RM. VistA--U.S. Department of Veterans Affairs national-scale HIS. Int J Med Inform. 2003;69(2–3):135–56.PubMedCrossRef

Jackson GL, Weinberger M. A decade with the chronic care model: some progress and opportunity for more. Med Care. 2009;47(9):929–31.PubMedCrossRef

Lukas CV, Meterko MM, Mohr D, et al. Implementation of a Clinical Innovation: The Case of Advanced Clinic Access in the Department of Veterans Affairs. J Ambul Care Manage. 2008;31(2):94–108.PubMed

Kizer KW, Dudley RA. Extreme makeover: transformation of the veterans health care system. Annu Rev Public Health. 2009;30:313–39.PubMedCrossRef

Chumbler NR, Haggstrom DA, Saleem J. Implementation of Health Information Technology in Veterans Health Administration to Support Transformational Change: Telehealth and Personal Health Records. Med Care. Apr 23 2010.

Nazi KM, Hogan TP, Wagner TH, et al. Embracing a health services research perspective on personal health records: lessons learned from the VA My HealtheVet system. J Gen Intern Med. 2010;25(Suppl 1):62–7.PubMedCrossRef

Darkins A, Ryan P, Kobb R, et al. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemed J E Health. 2008;14(10):1118–26.PubMedCrossRef

Tuerk PW, Fortney J, Bosworth HB, et al. Toward the development of national telehealth services: the role of veterans health administration and future directions for research. Telemed J E Health. 2010;16(1):115–7.PubMedCrossRef

Hynes DM, Weddle T, Smith N, Whittier E, Atkins D, Francis J. Use of health information technology to advance evidence-based care: lessons from the VA QUERI Program. J Gen Intern Med. 2010;25(Suppl 1):44–9.PubMedCrossRef

10.

Ralston JD, Martin DP, Anderson ML, et al. Group Health Cooperative's Transformation Toward Patient-Centered Access. Med Care Res Rev. Jun 23 2009.

11.

Jha AK, DesRoches CM, Campbell EG, et al. Use of electronic health records in U.S. hospitals. N Engl J Med. 2009;360(16):1628–38.PubMedCrossRef

12.

Desroches CM, Campbell EG, Rao SR, et al. Electronic Health Records in Ambulatory Care -- A National Survey of Physicians. N Engl J Med. Jun 18 2008.

13.

Blumenthal D, Tavenner M. The "meaningful use" regulation for electronic health records. N Engl J Med. 2010;363(6):501–4.PubMedCrossRef

14.

Whited JD, Datta SK, Aiello LM, et al. A modeled economic analysis of a digital tele-ophthalmology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy. Telemed J E Health. 2005;11(6):641–51.PubMedCrossRef

15.

Vest JR, Bolin JN, Miller TR, Gamm LD, Siegrist TE, Martinez LE. Medical homes: "where you stand on definitions depends on where you sit". Med Care Res Rev. 2010;67(4):393–411.PubMedCrossRef

16.

Nutting PA, Miller WL, Crabtree BF, Jaen CR, Stewart EE, Stange KC. Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. Ann Fam Med. 2009;7(3):254–60.PubMedCrossRef

17.

Young AS, Chaney E, Shoai R, et al. Information technology to support improved care for chronic illness. J Gen Intern Med. 2007;22(Suppl 3):425–30.PubMedCrossRef

18.

Mun SK, Pak H, Clyburn C, Collmann J, Tohme W, Levine BA. The executive summary of the National Forum on the Future of Defense Health Information Systems. Mil Med. 2009;174(5 Suppl):1–3.PubMed

19.

Kupersmith J, Francis J, Kerr E. Advancing evidence-based care for diabetes: lessons from the Veterans Health Administration. Health Aff (Millwood). 2007;26(2):156–68.CrossRef

20.

Box TL, McDonell M, Helfrich CD, Jesse RL, Fihn SD, Rumsfeld JS. Strategies from a nationwide health information technology implementation: the VA CART story. J Gen Intern Med. 2010;25(Suppl 1):72–6.PubMedCrossRef

21.

Jackson GL, Powell AA, Ordin DL, et al. Developing and sustaining quality improvement partnerships in the VA: the Colorectal Cancer Care Collaborative. J Gen Intern Med. 2010;25(Suppl 1):38–43.PubMedCrossRef

22.

McManus RJ, Glasziou P, Hayen A, et al. Blood pressure self monitoring: questions and answers from a national conference. BMJ. 2008;337:a2732.PubMedCrossRef

23.

Damush TM, Jackson GL, Powers BJ, et al. Implementing evidence-based patient self-management programs in the Veterans Health Administration: perspectives on delivery system design considerations. J Gen Intern Med. 2010;25(Suppl 1):68–71.PubMedCrossRef

24.

Heisler M, Vijan S, Makki F, Piette JD. Diabetes control with reciprocal peer support versus nurse care management: a randomized trial. Ann Intern Med. 2010;153(8):507–15.PubMed

25.

Morgan RO, Teal CR, Reddy SG, Ford ME, Ashton CM. Measurement in Veterans Affairs Health Services Research: veterans as a special population. Health Serv Res. 2005;40(5 Pt 2):1573–83.PubMedCrossRef

26.

Williams JW Jr. Serving the health needs of our military and veterans. N C Med J. 2008;69(1):23–6.PubMed

27.

Wallace AE, MacKenzie TA, Wright SM, Weeks WB. A cross-sectional, multi-year examination of rural and urban Veterans Administration users: 2002–2006. Mil Med. 2010;175(4):252–8.PubMed

28.

Cully JA, Jameson JP, Phillips LL, Kunik ME, Fortney JC. Use of psychotherapy by rural and urban veterans. J Rural Health. 2010;26(3):225–33.PubMedCrossRef

29.

Cho AH, Arar NH, Edelman DE, Hartwell PH, Oddone EZ, Yancy WS Jr. Do diabetic veterans use the Internet? Self-reported usage, skills, and interest in using My HealtheVet web portal. Telemed J E Health. 2010;16(5):595–602.PubMedCrossRef

30.

Alverson DC, Holtz B, D'Iorio J, DeVany M, Simmons S, Poropatich RK. One size doesn't fit all: bringing telehealth services to special populations. Telemed J E Health. 2008;14(9):957–63.PubMedCrossRef

31.

Nazi KM. Veterans' voices: use of the American Customer Satisfaction Index (ACSI) Survey to identify My HealtheVet personal health record users' characteristics, needs, and preferences. J Am Med Inform Assoc. 2010;17(2):203–11.PubMedCrossRef

32.

Roblin DW, Houston TK, Allison JJ, Joski PJ, Becker ER. Disparities in use of a personal health record in a managed care organization. J Am Med Inform Assoc. 2009;16(5):683–9.PubMedCrossRef

33.

Levine DA, Allison JJ, Cherrington A, Richman J, Scarinci IC, Houston TK. Disparities in self-monitoring of blood glucose among low-income ethnic minority populations with diabetes. United States. Ethn Dis. Spring. 2009;19(2):97–103.

34.

Bakken S, Ruland CM. Translating clinical informatics interventions into routine clinical care: how can the RE-AIM framework help? J Am Med Inform Assoc. 2009;16(6):889–97.PubMedCrossRef

35.

Pizziferri L, Kittler AF, Volk LA, et al. Primary care physician time utilization before and after implementation of an electronic health record: a time-motion study. J Biomed Inform. 2005;38(3):176–88.PubMedCrossRef

36.

Pizziferri L, Kittler AF, Volk LA, et al. Impact of an Electronic Health Record on oncologists' clinic time. AMIA Annu Symp Proc. 2005:1083.

37.

Liederman EM, Lee JC, Baquero VH, Seites PG. Patient-physician web messaging. The impact on message volume and satisfaction. J Gen Intern Med. 2005;20(1):52–7.PubMedCrossRef

38.

Helfrich CD, Weiner BJ, McKinney MM, Minasian L. Determinants of implementation effectiveness: adapting a framework for complex innovations. Med Care Res Rev. 2007;64(3):279–303.PubMedCrossRef

39.

Weiner BJ, Amick H, Lee SY. Conceptualization and measurement of organizational readiness for change: a review of the literature in health services research and other fields. Med Care Res Rev. 2008;65(4):379–436.PubMedCrossRef

40.

Liu CF, Chapko M, Bryson CL, et al. Use of outpatient care in Veterans Health Administration and Medicare among veterans receiving primary care in community-based and hospital outpatient clinics. Health Serv Res. 2010;45(5 Pt 1):1268–86.PubMedCrossRef

41.

Ahern DK, Woods SS, Lightowler MC, Finley SW, Houston TK. Promise of and potential for patient-facing technologies to enable meaningful use. Am J Prev Med. 2011;40(5 Suppl 2):S162–72.PubMedCrossRef

42.

Ralston JD, Carrell D, Reid R, Anderson M, Moran M, Hereford J. Patient web services integrated with a shared medical record: patient use and satisfaction. J Am Med Inform Assoc. 2007;14(6):798–806.PubMedCrossRef

43.

Harrison MI, Koppel R, Bar-Lev S. Unintended consequences of information technologies in health care–an interactive sociotechnical analysis. J Am Med Inform Assoc. 2007;14(5):542–9.PubMedCrossRef

44.

Demakis JG, Beauchamp C, Cull WL, et al. Improving residents' compliance with standards of ambulatory care: results from the VA Cooperative Study on Computerized Reminders. JAMA. 2000;284(11):1411–6.PubMedCrossRef

45.

Gosbee J. Introduction to the human factors engineering series. Jt Comm J Qual Saf. 2004;30(4):215–9.PubMed

46.

Weiner BJ, Lewis MA, Linnan LA. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Educ Res. 2009;24(2):292–305.PubMedCrossRef

47.

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.PubMedCrossRef

48.

Stetler CB, Legro MW, Wallace CM, et al. The role of formative evaluation in implementation research and the QUERI experience. J Gen Intern Med. 2006;21(Suppl 2):S1–8.PubMedCrossRef

49.

Stetler CB, Mittman BS, Francis J. Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI Series. Implement Sci. 2008;3:8.PubMedCrossRef

50.

Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322–7.PubMedCrossRef

Titel: Defining Core Issues in Utilizing Information Technology to Improve Access: Evaluation and Research Agenda
verfasst von: George L. Jackson, PhD, MHA
Sarah L. Krein, PhD, RN
Dale C. Alverson, MD
Adam W. Darkins, MD, MPH
William Gunnar, MD, JD
Nancy D. Harada, PhD, PT
Christian D. Helfrich, PhD, MPH
Thomas K. Houston, MD, MPH
Thomas F. Klobucar, PhD
Kim M. Nazi, PhD
Ronald K. Poropatich, MD
James D. Ralston, MD, MPH
Hayden B. Bosworth, PhD
Publikationsdatum: 01.11.2011
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe Sonderheft 2/2011
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-011-1789-3

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