Do electronic health records used by primary care practices support recommended alcohol-related care?

Autor: Bradley K; Kaiser Permanente Health Plan of Washington, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States., McCormack J; Oregon Health & Science University, Oregon Rural Practice-based Research Network, Portland, OR 97239, United States., Addis M; Kaiser Permanente Health Plan of Washington, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States., Hamilton LK; Kaiser Permanente Health Plan of Washington, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States., Lapham GT; Kaiser Permanente Health Plan of Washington, Kaiser Permanente Washington Health Research Institute, Seattle, WA 98101, United States., Jonas D; Division of General internal Medicine, The Ohio State University, Columbus, OH 43221, United States., Bishop D; Altarum, Ann Arbor, MI 48105, United States., Parsons D; Altarum, Ann Arbor, MI 48105, United States., Budimir C; Altarum, Ann Arbor, MI 48105, United States., Sanchez V; Oregon Health & Science University, Oregon Rural Practice-based Research Network, Portland, OR 97239, United States., Bannon J; Center for Health Information Partnerships, Northwestern University, Evanston, IL 60611, United States., Villalobos G; Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23219, United States., Krist AH; Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA 23219, United States., Walunas T; Center for Health Information Partnerships, Northwestern University, Evanston, IL 60611, United States., Day A; Altarum, Ann Arbor, MI 48105, United States.
Jazyk: angličtina
Zdroj: JAMIA open [JAMIA Open] 2024 Dec 04; Vol. 7 (4), pp. ooae125. Date of Electronic Publication: 2024 Dec 04 (Print Publication: 2024).
DOI: 10.1093/jamiaopen/ooae125
Abstrakt: Objective: The quality of alcohol-related prevention and treatment in US primary care is poor. The purpose of this study was to describe the extent to which Electronic Health Records (EHRs) used by 167 primary care practices across 7 states currently include the necessary prompts, clinical support, and performance reporting essential for improving alcohol-related prevention and treatment in primary care.
Materials and Methods: Experts from five regional quality improvement programs identified basic EHR features needed to support evidence-based alcohol-related prevention (ie, screening and brief intervention) and treatment of alcohol use disorders (AUD). Data were collected regarding whether EHRs included these features.
Results: EHRs from 21 vendors were used by the primary care practices. For prevention, 62% of the 167 practices' EHRs included a validated screening questionnaire, 46% automatically scored the screening instrument, 62% could report the percent screened, and 37% could report the percent screening positive. Only 7% could report the percent offered brief intervention. For alcohol treatment, 49% of practices could report the percent diagnosed with AUD, 58% and 91% allowed documentation of referral and treatment with AUD medication, respectively. Only 3% could report the percent of patients diagnosed with AUD who received treatment.
Discussion: Most EHRs observed across 167 primary care practices across 7 US states lacked basic functionality necessary to support evidence-based alcohol-related prevention and AUD treatment. Only 3% and 7% of EHRs, respectively, included the ability to report widely recommended quality measures needed to improve the quality of recommended alcohol-related prevention and treatment in primary care.
Conclusion: Improving EHR functionality is likely necessary before alcohol-related primary care can be improved.
Competing Interests: The authors have no competing interests to declare.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)
Databáze: MEDLINE