Getting in step: Electronic health records and their role in care coordination

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Abstract

Comments on an article by A. S. O’Malley et al. (see record [rid]2010-05511-003[/rid]). O’Malley et al. present arguably the most comprehensive assessment to date of the ability of the current iteration of vendor-developed electronic health records (EHRs) to assist providers with care coordination. To do their assessment, the researchers used qualitative techniques, and performed 60 interviews in a national sample of practices using 17 different commercial EHRs. They identified six key themes: 1) that EHRs needed to help with in-office communications—which they generally did adequately; 2) that they also needed to help with communication between clinicians and settings which was much less satisfactory; 3) that clinicians found information overflow a challenge; 4) that current records don not support care coordination planning; 5) that care coordination processes need to evolve; and 6) not surprisingly, that fee-for-service payment encourages billable event documentation, but not care coordination. But as O’Malley et al. found, these tools simply do not exist today in most EHRs, which means they will need to be developed. Even the underlying processes in practices in these areas are likely to evolve substantially in the coming years. This should be a key area of attention for SGIM members in the next several years, since it is especially important that this work well in primary care. The current work by O’Malley et al. represents some of the best to date on how EHRs support care coordination, which again is a crucial function. Moving ahead will require more research in this area, as today’s processes are immature and all of this will need to be interfaced with the medical home concept. Improving this could hardly be more important, as the patients who get the most benefit from care coordination account for a huge proportion of the costs in our healthcare system. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Author-supplied keywords

  • Chronic diseases
  • Health care policy
  • Health information technology
  • Meaningful use

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Authors

  • David W. Bates

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