BMC Med Inform Decis Mak - Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system.

Tópicos

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Resumo

CKGROUND: Meaningful Use (MU) provides financial incentives for electronic health record (EHR) implementation. EHR implementation holds promise for improving healthcare delivery, but also requires substantial changes for providers and staff. Establishing readiness for these changes may be important for realizing potential EHR benefits. Our study assesses whether provider/staff perceptions about the appropriateness of MU and their departments' ability to support MU-related changes are associated with their reported readiness for MU-related changes.METHODS: We surveyed providers and staff representing 47 ambulatory practices within an integrated delivery system. We assessed whether respondent's role and practice-setting type (primary versus specialty care) were associated with reported readiness for MU (i.e., willingness to change practice behavior and ability to document actions for MU) and hypothesized predictors of readiness (i.e., perceived appropriateness of MU and department support for MU). We then assessed associations between reported readiness and the hypothesized predictors of readiness.RESULTS: In total, 400 providers/staff responded (response rate approximately 25%). Individuals working in specialty settings were more likely to report that MU will divert attention from other patient-care priorities (12.6% vs. 4.4%, p = 0.019), as compared to those in primary-care settings. As compared to advanced-practice providers and nursing staff, physicians were less likely to have strong confidence in their department's ability to solve MU implementation problems (28.4% vs. 47.1% vs. 42.6%, p = 0.023) and to report strong willingness to change their work practices for MU (57.9% vs. 83.3% vs. 82.0%, p < 0.001). Finally, provider/staff perceptions about whether MU aligns with departmental goals (OR = 3.99, 95% confidence interval (CI) = 2.13 to 7.48); MU will divert attention from other patient-care priorities (OR = 2.26, 95% CI = 1.26 to 4.06); their department will support MU-related change efforts (OR = 3.99, 95% CI = 2.13 to 7.48); and their department will be able to solve MU implementation problems (OR = 2.26, 95% CI = 1.26 to 4.06) were associated with their willingness to change practice behavior for MU.CONCLUSIONS: Organizational leaders should gauge provider/staff perceptions about appropriateness and management support of MU-related change, as these perceptions might be related to subsequent implementation.

Resumo Limpo

ckground meaning use mu provid financi incent electron health record ehr implement ehr implement hold promis improv healthcar deliveri also requir substanti chang provid staff establish readi chang may import realiz potenti ehr benefit studi assess whether providerstaff percept appropri mu depart abil support murel chang associ report readi murel changesmethod survey provid staff repres ambulatori practic within integr deliveri system assess whether respond role practiceset type primari versus specialti care associ report readi mu ie willing chang practic behavior abil document action mu hypothes predictor readi ie perceiv appropri mu depart support mu assess associ report readi hypothes predictor readinessresult total providersstaff respond respons rate approxim individu work specialti set like report mu will divert attent patientcar prioriti vs p compar primarycar set compar advancedpractic provid nurs staff physician less like strong confid depart abil solv mu implement problem vs vs p report strong willing chang work practic mu vs vs p final providerstaff percept whether mu align department goal confid interv ci mu will divert attent patientcar prioriti ci depart will support murel chang effort ci depart will abl solv mu implement problem ci associ willing chang practic behavior muconclus organiz leader gaug providerstaff percept appropri manag support murel chang percept might relat subsequ implement

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