Project Details - Ongoing
- Grant Number:R01 HS023324
- Funding Mechanism:
- AHRQ Funded Amount:$1,987,438
- Principal Investigator:
- Project Dates:5/1/2015 to 4/30/2020
- Care Setting:
- Type of Care:
- Health Care Theme:
Managing patient information can be particularly difficult when serving complex patients who have multiple physical, mental, and social needs, and are often seen by multiple health care professionals. When coordinating care for such patients, primary care clinicians and their staff must locate, obtain, and synthesize the wide range of information needed to assess patients, make clinical decisions, monitor progress, and identify care goals. They also must identify the people involved in the patient’s care, and share information effectively, even with members of the care team located in other settings. Health information technology (IT) that optimally supports the information access, management, and sharing required for effective care coordination is critical to addressing this complicated set of information needs. Yet, while health IT tools--especially electronic health records (EHRs)--are becoming common in primary care practice, such tools are rarely designed specifically to address primary care teams’ information management needs in the context of providing and coordinating care for complex patients. As a result, such IT systems can actually lead to care fragmentation, inefficiencies, and workarounds leading to errors and lower quality care.
This project will identify the information needs that must be met to ensure effective care coordination for complex patients through extensive ethnographic assessment and interviews, and employ user-centered design methods to rapidly develop and test health IT tools that address these needs. This work will be conducted in partnership with OCHIN, Inc., a non-profit organization nationally recognized for its health IT innovations. The study will be conducted at 10 OCHIN-affiliated community health centers (CHCs).
The specific aims of the project are as follows:
- Identify CHC clinicians’ and clinical teams’ information needs when they work individually and collaboratively to coordinate care for complex patients
- Identify CHC clinicians’ and clinical teams’ information needs regarding patients’ social determinants of health, and methods for obtaining this information and integrating it into the EHR so as to inform clinical decisionmaking when caring for complex patients
- Identify design principles and use proven development methods to rapidly develop and test health IT tools to meet the health IT needs identified in Aims 1 and 2
This study will provide a set of practice and actionable design principles that will be widely disseminated as well as health IT tools that demonstrate these principles that will be ready for implementation in the OCHIN network and among other EHR users.