transforming the office management of heart failure using the chronic disease model in a residenc
TRANSCRIPT
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Information Technology in PBRN PracticesSurvey vs. Site Visit
Donald E. Nease, Jr, Lee A. Green, Aartee Ignazcek, Patricia Watkins, John Calcagni, Gabe Thompson
University of MichiganDepartment of Family Medicine
Funded by: AHRQ R03 HS14413
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why IT & PBRNs?
• practice electronic data
• demographics, diagnoses, services
• availability of internet access
• communication, distribution & return of study related information & materials
• collection of data via webPace WD, Staton EW. Electronic data collection options for practice-based
research networks. Ann Fam Med. 2005 May-Jun;3 Suppl 1:S21-9.
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prior work• Andrews, et. al., 2004
• Kentucky Ambulatory Network (KAN)
• mailed survey of 68 office managers & 116 clinicians (46% & 51% resp. rate)
• 100% using electronic billing
• 50% have a LAN; internet in all but one
• 94% electronic scheduling
• 21% with an EMRAndrews JE, Pearce KA, Sydney C, Ireson C, Love M. Current state of information technology use in a
US primary care practice-based research network. Inform Prim Care. 2004;12(1):11-8.
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GRIPSGRIN Research Infrastructure Practice Survey
• Aim: Conduct on-site detailed structural and functional assessments of GRIN practices focused on:
• current use of information systems
• billing
• electronic medical records
• reminder systems
• internet
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methods
• Pre-visit survey - immediately prior to visit
• Visit
• Interviews with office manager, clinicians & staff
• Detailed observations
• Post-visit report
• Did we get it right?
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GRIPS so far
• 33 surveyed & visited (target = 50)
• 85% have no academic affiliation
• Mean # physicians - 3.5 (2.8)
• Mean # extenders - 1.3 (0.9) among those who have them
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results - connectivity
0%
25%
50%
75%
100%
survey visit3%
13%
97%87%
yes no
are your computers networked?
41%
59%
yes no
internet access at all workstations?
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results - office systems
• 50% of those checking “no” on the survey actually do
• One practice that checked “yes” on the survey actually does not
0%
25%
50%
75%
100%
survey visit
13%17%
87%83%
yes no
do you utilize computerized billing?
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results - office systems
0%
25%
50%
75%
100%
survey visit6%6%
94%94%
yes no
do you utilize computerized scheduling?
29%71%
yes no
computerized demographic reports?
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results - office systems
0%
25%
50%
75%
100%
survey visit
70%73%
30%27%
yes no
do you utilize an EMR?
20%
80%
yes no
use an EMR beyond basic charting?
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results - IT support
0%
25%
50%
75%
100%
survey visit
93%
67%
7%
33%
internal external
IT staff internal or external is IT support externally contracted?
42%
58%
yes no
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conclusions
• GRIN PBRN practices visited so far...
• IT infrastructure limited to basic office systems
• may not be useful for enabling research
• Survey data alone may not give an accurate picture