Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes

Describes in detail eight change concepts as a guide to transforming a practice into a patient-centered medical home, including engaged leadership, quality improvement strategy, continuous and team-based healing relationships, and enhanced access

Sentara Healthcare: A Case Study Series on Disruptive Innovation Within Integrated Health Systems

Examines how integration and ties with health plans, physicians, and hospitals helped protect against revenue volatility and enabled experimentation; factors that facilitate integration; innovative practices; lessons learned; and policy implications

Email for clinical communication between healthcare professionals

Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals

Strengthening Primary and Chronic Care: State Innovations to Transform and Link Small Practices

Presents case studies of state policies for reorganizing and improving primary and chronic care delivery among small practices, including leadership and convening, payment incentives, infrastructure support, feedback and monitoring, and certification

Understanding Challenges and Solutions with Systemigrams: Application to Electronic Medical Record Systems

The medical field is becoming bigger and more complex in the 21st century, diseases both emergent and re-emergent are on the rise and are costing lives around the world. Evolution of many diseases has made people find a reason to seek medical care in healthcare centers. This has led to increased development of health care facilities as peoples’ urge to get quality diagnosis and treatment rises. However, in the past patients ended up waiting a long time in their efforts to obtain these services. These wait times were due to the lack of proper documentation and recording of the personal information. Hospitals and health centers had to hire an increased numbers of health practitioners to handle the paper work as patient populations increased. Due to the massive amount of issues experienced and the patient agony, healthcare professionals were prompted to develop fast, reliable and efficient methods of handling large amounts of data within a short time. The rise of digital technologies enables the Electronic Medical Records (EMR) system to be utilized in the healthcare setting. This tool has revolutionized the whole spectrum of capturing and recording medical health data. Today, health care agencies and organizations can retrieve and store a patient’s personal health information where physicians can readily access this information from their offices. Therefore, EMR is the real time solution to the health information management problem and through it there will be an improved patient experience in terms of wait time, diagnosis, and treatment. However, there are some challenges that come with the system that should be addressed to ensure efficiency. After a systemic review of the literature, we have used a systemigram approach and modeled the current challenges of EMR implementation and the related solutions to EMR system adoption. The objective of this study is to provide a systems-thinking approach to better contextualize the role of EMR in the complex system of healthcare from a multi-stakeholder perspective

Improving the Use of Electronic Medical Records in Primary Health Care: A Systematic Review and Meta-Analysis

Electronic Medical Records were first introduced in the 1970s to organize patient information, improve coordination of care, and improve communication. The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary health care settings. Of 2,098 identified studies twelve were included in the review. Results showed that interventions focused on the use of EMR functions were five times more likely to show improvements in EMR use compared to controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared to controls. Individuals in primary health care settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality

Email for clinical communication between healthcare professionals

Background Email is a popular and commonly-used method of communication, but its use in healthcare is not routine. Where email communication has been utilised in health care, its purposes have included use for clinical communication between healthcare professionals, but the effects of using email in this way are not known. This review assesses the use of email for two-way clinical communication between healthcare professionals. Objectives To assess the effects of healthcare professionals using email to communicate clinical information, on healthcare professional outcomes, patient outcomes, health service performance, and service efficiency and acceptability, when compared to other forms of communicating clinical information. Search methods We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors. Selection criteria Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions in which healthcare professionals used email for communicating clinical information, and that took the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Data collection and analysis Two authors independently assessed studies for inclusion, assessed the included studies' risk of bias, and extracted data. We contacted study authors for additional information. We report all measures as per the study report. Main results We included one randomised controlled trial involving 327 patients and 159 healthcare providers at baseline. It compared an email to physicians containing patient-specific osteoporosis risk information and guidelines for evaluation and treatment with usual care (no email). This study was at high risk of bias for the allocation concealment and blinding domains. The email reminder changed health professional actions significantly, with professionals more likely to provide guideline-recommended osteoporosis treatment (bone density measurement and/or osteoporosis medication) when compared with usual care. The evidence for its impact on patient behaviours/actions was inconclusive. One measure found that the electronic medical reminder message impacted patient behaviour positively: patients had a higher calcium intake, and two found no difference between the two groups. The study did not assess primary health service outcomes or harms. Authors' conclusions As only one study was identified for inclusion, the results are inadequate to inform clinical practice in regard to the use of email for clinical communication between healthcare professionals. Future research needs to use high-quality study designs that take advantage of the most recent developments in information technology, with consideration of the complexity of email as an intervention, and costs