EHR-Based Care Coordination Performance Measures in Ambulatory Care

Describes electronic health record-based measures for assessing coordination in referrals, including information communicated with referral, communication to patient, and specialist report to primary care physician. Offers preliminary evaluation findings

Continuing research training: MEWAC tracer study TIOE & TIHE final report

Executive Summary: The two main objectives of this study are to: 1) provide an electronic and physical data base of all researches and studies conducted in Tongan education in the last 15 years, and; 2) provide data on the employability and experiences of the graduates of the Tonga Institute of Education(TIOE) and the Tonga Institute of Higher Education (TIHE) that have graduated in the last five years (2007 – 2011). The study showed that graduates of both TIOE and TIHE have very high employability status. Data has also shown that graduates from both institutions spend minimal time in trying to find employment. Almost half the graduates from TIOE and two-thirds of the graduates from TIHE find employment within 3 months and one-fifth from TIOE and one-thirds from TIHE found employment in less than 5 months.Most graduates from both institutions were happy with their jobs but need improvement in their skills. A database had also been put together as reference point for Tongan students, teachers and interested persons recording studies and researches that are related to Tongan education. This database can be updated regularly to help anybody but especially the students at both TIOE and TIHE

The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program

PURPOSE. This study compares a traditional worksite-based health promotion program with an activated consumer program and a control program DESIGN. Group randomized controlled trial with 18-month intervention. SETTING. Two large Midwestern companies. SUBJECTS. Three hundred and twenty employees (51% response). INTERVENTION. The traditional health promotion intervention offered population-level campaigns on physical activity, nutrition, and stress management. The activated consumer intervention included population-level campaigns for evaluating health information, choosing a health benefits plan, and understanding the risks of not taking medications as prescribed. The personal development intervention (control group) offered information on hobbies. The interventions also offered individual-level coaching for high risk individuals in both active intervention groups. MEASURES. Health risk status, general health status, consumer activation, productivity, and the ability to evaluate health information. ANALYSIS. Multivariate analyses controlled for baseline differences among the study groups. RESULTS. At the population level, compared with baseline performance, the traditional health promotion intervention improved health risk status, consumer activation, and the ability to recognize reliable health websites. Compared with baseline performance, the activated consumer intervention improved consumer activation, productivity, and the ability to recognize reliable health websites. At the population level, however, only the activated consumer intervention improved any outcome more than the control group did; that outcome was consumer activation. At the individual level for high risk individuals, both traditional health coaching and activated consumer coaching positively affected health risk status and consumer activation. In addition, both coaching interventions improved participant ability to recognize a reliable health website. Consumer activation coaching also significantly improved self-reported productivity. CONCLUSION. An effective intervention can change employee health risk status and activation both at the population level and at the individual high risk level. However, program engagement at the population level was low, indicating that additional promotional strategies, such as greater use of incentives, need to be examined. Less intensive coaching can be as effective as more intensive, albeit both interventions produced modest behavior change and retention in the consumer activation arm was most difficult. Further research is needed concerning recruitment and retention methods that will enable populations to realize the full potential of activated consumerism

No change in physician dictation patterns when visit notes are available online for patients

OBJECTIVE To determine whether physicians document office visits differently when they know their patients have easy, online access to visit notes. PATIENTS AND METHODS We conducted a natural experiment with a pre-post design and a nonrandomized control group. The setting was a multispecialty group practice in Minnesota. We reviewed a total of 400 visit notes: 100 each for patients seen in a rheumatology department (intervention group) and a pulmonary medicine department (control group) from July 1 to August 30, 2005, before online access to notes, and 100 each for patients seen in these 2 departments 1 year later, from July 1 to August 30, 2006, when only rheumatology patients had online access to visit notes. We measured changes in visit note content related to 9 hypotheses for increased patient understanding and 5 for decreased frank or judgmental language. RESULTS Changes occurred for 2 of the 9 hypotheses related to patient understanding, both in an unpredicted direction. The proportion of acronyms or abbreviations increased more in the notes of rheumatologists than of pulmonologists (0.6% vs 0.1%; P=.01), whereas the proportion of anatomy understood decreased more in the notes of rheumatologists than of pulmonologists (−5.9% vs −0.8%; P=.02). One change (of 5 possible) occurred related to the use of frank or judgmental terms. Mentions of mental health status decreased in rheumatology notes and increased in pulmonology notes (−8% vs 7%; P=.02). CONCLUSION Dictation patterns appear relatively stable over time with or without online patient access to visit notes

No Change in Physician Dictation Patterns When Visit Notes Are Made Available Online for Patients

OBJECTIVE: To determine whether physicians document office visits differently when they know their patients have easy, online access to visit notes