Although incorporating seamless functionality into patient health records to seems to be a lynchpin of the ideal healthcare landscape, the limitations of current health IT, namely EHRs, may be preventing physicians from achieving coordinated care goals, according to a new study.
In a survey of 350 small and large physician-owned practices, researchers found that the care-coordination activities most routinely implemented were not the ones with greatest degree of health IT support. The results were published in Annals of Family Medicine.
"Even among more advanced patient-centered medical home practices, there was only moderate health IT support for many of the care-coordination activities such as tracking referrals and identifying hospital and emergency room discharges," Suzanne Morton, corresponding author and senior health care analyst for the National Committee for Quality Assurance, told AAFP News. "We were also surprised that some of the activities for which clinicians considered it very important to have health IT support — such as identifying hospital discharges and seeing reports that come back from specialists — currently had the least health IT support. Conversely, providing clinical summaries for patients, which had high electronic support, was seen as less important to clinicians."
Here are seven key findings related to routine performance of care-coordination activities and the routine use of health IT to conduct them.
• 81.4 percent of practices provided patients with clinical summaries of their visits; 76.6 percent routinely used health IT to do so
• 92.3 percent sent referral requests to other clinicians; 68.6 percent used health IT
• 69.4 percent provided a comprehensive medical summary for each site transition or referral; 45.4 percent used health IT
• 90 percent responded to requests for additional information from a clinician receiving a referral; 54 percent used health IT
• 74.3 percent provided reminders for guideline-based interventions or screening tests to clinicians at the point of care; 64.9 percent used health IT
• 63.1 percent identified patient who had been to the ER; 39.4 percent used health IT
• 75.4 percent identified patients admitted to or discharged from the hospital; 48.9 percent used health IT
Physicians reported time, money and other resources as barriers to their ability to coordinate patient care, in addition to health IT and EHR systems.
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