Project Details -
Completed
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Grant NumberUC1 HS015316
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AHRQ Funded Amount$1,500,000
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Principal Investigator(s)
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Organization
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LocationFishkillNew York
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Project Dates09/30/2004 - 03/31/2008
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Care Setting
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Type of Care
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Health Care Theme
The Taconic IPA, a 3,000 physician independent practice association located in Fishkill, NY involved in an information technology project to improve the quality, safety, and efficiency of healthcare in our region. In the past, the organization worked with area hospitals and laboratories to create a community wide electronic data exchange. At the beginning of the project, Taconic IPA physicians electronically managed the data through a clinical messaging system as part of their daily workflow, which is the first step in adoption of an electronic health record (EHR). The Taconic IPA added a health care portal to the existing community wide electronic data exchange which allowed for use of the current electronic messaging system along with migration to a full EHR. We believed that a full EHR with clinical decision support and patient registries was required to signficantly improve the quality, safety, and efficiency of health care. Most uniform EHR systems have been developed and deployed in Integrated Delivery Systems or large university hospitals under a staff model setting. Independently practicing physicians and competing community hospitals do not engage in efforts to deploy interoperable systems with standards and common vocabularies necessary to address quality improvement on a population-based and individual physician basis. The IPA was one of the first to attempt deployment of a standard EHR with a community wide electronic data exchange among a large group of independently practicing physicians as has been done in staff model settings. Although studies have demonstrated cost savings and, to a limited extent, quality improvement in staff model implementations, large controlled trials do not exist in the private practice setting. Our project evaluated: physician office efficiency improvement and cost reduction, payer return on investment, safety improvement, and quality improvement. The groups evaluated included a control group, the group using the electronic messaging system, and a group using a full EHR.