A Study of an EHR to Translate Public Health Practices

电子病历转化公共卫生实践的研究

• 批准号: 7684193
• 负责人: Rita Kukafka
• 金额: $ 44.8万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-29 至 2011-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7684193
• 关键词: Study; EHR; Translate; Public; Health

DESCRIPTION (provided by applicant): Ample evidence demonstrates that public health elements such as preventive care reminders, quality measurement, immunization registries, and patient education materials provide public health value, yet dissemination is poor. Electronic health records (EHRs) may provide a solution, but poor EHR adoption and poor incorporation of public health elements into EHRs limit their broad use. The New York City government is carrying out a unique project to improve the health of the city, investing over $27 million to implement a public health enabled EHR (PHEEHR) to providers who treat underserved patients throughout the city. Our project is to study this PHEEHR New York City implementation with the goal of discovering strategies that can enhance PHEEHR adoption and impact. Specific aims are 1) to study the implementation process by examining across practice settings the contextual factors that contribute to the adoption and impact of the PHEEHR; 2) to study how the complex relationships between public health elements and environmental task elements facilitate or hamper adoption and impact of the PHEEHR and 3) to develop and disseminate generalizable conclusions based on the results of aims 1 and 2. We will use the DeLone and McLean Information System Model to evaluate the causal paths that begin with the PHEEHR system itself, and incorporate user satisfaction, adoption, and impact. Impact in this study is multifaceted measured in part by an increase in the proportion of provider sites that perform preventative services and public health reporting based on Healthy People 2010 and the U.S. Preventive Services Task Force guidelines. The DeLone and McLean model and an extended model with a task-technology fit construct will be empirically tested with quantitative qualitative and relational data collected from 327 practice settings. Multilevel structural equation modeling (ML-SEM) will be used to evaluate both models. To maximize the generalizability of our findings, we will adhere to standardized multidimensional reporting metrics from the RE-AIM framework specifically designed to improve the translatability of research findings. Our goal is to extend what we learn from this unprecedented New York City PHHEHR implementation research study to inform others that are likely to engage in similar PHEEHR implementations in the future.

描述（由申请人提供）： 充分的证据表明，诸如预防保健提醒，质量测量，免疫登记和患者教育材料等公共卫生元素提供了公共卫生价值，但传播却很差。电子健康记录（EHRS）可以提供解决方案，但是EHR的采用率较差，公共卫生元素纳入EHRS中的不良局限于限制其广泛使用。纽约市政府正在进行一个独特的项目，以改善城市的健康状况，投资超过2700万美元，以实施启用公共卫生的EHR（Pheehr），向整个城市中服务不足的患者提供服务的提供者。我们的项目是研究纽约市的Pheehr实施，目的是发现可以增强Pheehr采用和影响的策略。具体目标是1）通过在跨实践环境中检查有助于Pheehr采用和影响的上下文因素来研究实施过程； 2）研究公共卫生要素与环境任务要素之间的复杂关系如何促进或阻碍Pheehr和3）基于目标1和2的结果来制定和传播可推广的结论。我们将使用DeLone和McLean信息系统模型来评估Pheehr System Inffems Insupt and Indulate sermution and Indul Inction AndersAction，并采用满足pheehr System and Anduction and Action Action Anders Actions，并采用pheehr Information模型。在这项研究中的影响是多方面的部分衡量，部分原因是根据Healthy People 2010和美国预防服务工作组指南的提供者的比例增加了提供预防服务和公共卫生报告的提供者的比例。 DeLone和McLean模型以及具有任务技术拟合结构的扩展模型将通过从327个实践设置中收集的定量定性和关系数据进行经验测试。多级结构方程建模（ML-SEM）将用于评估这两个模型。为了最大程度地提高发现结果的概括性，我们将遵守RE-AIM框架的标准化多维报告指标，专门旨在提高研究结果的转换性。我们的目标是扩展我们从这个史无前例的纽约市Phhehr实施研究中学到的知识，以告知其他可能在将来从事类似Pheehr实施的人。