Supplemental Material - Which Outreach Modes Improve Response Rates to Physician Surveys? Lessons from an Experiment at the American Board of Internal Medicine

Supplemental Material for Which Outreach Modes Improve Response Rates to Physician Surveys? Lessons from an Experiment at the American Board of Internal Medicine by Brendan J. Barnhart, Siddharta G. Reddy, and Jonathan L. Vandergrift in Evaluation & the Health Professions</p

Measurement in Veterans Affairs Health Services Research: Veterans as a Special Population

OBJECTIVE: To introduce this supplemental issue on measurement within health services research by using the population of U.S. veterans as an illustrative example of population and system influences on measurement quality. PRINCIPAL FINDINGS: Measurement quality may be affected by differences in demographic characteristics, illness burden, psychological health, cultural identity, or health care setting. The U.S. veteran population and the VA health system represent a microcosm in which a broad range of measurement issues can be assessed. CONCLUSIONS: Measurement is the foundation on which health decisions are made. Poor measurement quality can affect both the quality of health care decisions and decisions about health care policy. The accompanying articles in this issue highlight a subset of measurement issues that have applicability to the broad community of health services research. It is our hope that they stimulate a broad discussion of the measurement challenges posed by conducting “state-of-the-art” health services research

Prevalence and functionality of electronic health records in internal medicine continuity clinics.

PURPOSE: Health information technology (HIT), particularly electronic health records (EHRs), will become universal in ambulatory practices, but the current roles and functions that HIT and EHRs play in the ambulatory clinic settings of internal medicine (IM) residents are unknown. METHOD: The authors conducted a Web-based survey from July 2007 to January 2008 to ascertain HIT prevalence and functionality. Respondents were directors of one or more ambulatory clinics where IM residents completed any required outpatient training, as identified by directors of accredited U.S. IM residencies. RESULTS: The authors identified 356 clinic directors from 264 accredited U.S. programs (70%); 221 directors (62%) completed the survey, representing 185 accredited programs (49%). According to responding directors, residents in 121 of 216 clinics (56%) had access to EHRs, residents in 147 of 219 clinics (67%) used some type of electronic data system (EDS) to manage patient information, and residents in 62 clinics (28% of 219 responding) used an EDS to generate lists of patients needing follow-up care. Compared with smaller IM training programs, programs with \u3e or =50 trainees were more likely to have an EDS (67% versus 53%, P = .037), electronic prescription writer (57% versus 42%, P = .026), or EHR (63% versus 45%, P = .007). CONCLUSIONS: Resident ambulatory clinics seem to have greater adoption of HIT and EHRs than practicing physicians\u27 ambulatory offices. Ample room for improvement exists, however, as electronic systems with suboptimal patient data, limited functionality, and reliance on multiple (paper and electronic) systems all hinder residents\u27 ability to perform important care coordination activities