Do electronic health records used by primary care practices support recommended alcohol-related care?

IF 2.5 Q2 HEALTH CARE SCIENCES & SERVICES
JAMIA Open Pub Date : 2024-12-04 eCollection Date: 2024-12-01 DOI:10.1093/jamiaopen/ooae125
Katharine Bradley, James McCormack, Megan Addis, Leah K Hamilton, Gwen T Lapham, Daniel Jonas, Dawn Bishop, Darla Parsons, Cheryl Budimir, Victoria Sanchez, Jennifer Bannon, Gabriela Villalobos, Alex H Krist, Theresa Walunas, Anya Day
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Abstract

Objective: The quality of alcohol-related prevention and treatment in US primary care is poor. The purpose of this study was to describe the extent to which Electronic Health Records (EHRs) used by 167 primary care practices across 7 states currently include the necessary prompts, clinical support, and performance reporting essential for improving alcohol-related prevention and treatment in primary care.

Materials and methods: Experts from five regional quality improvement programs identified basic EHR features needed to support evidence-based alcohol-related prevention (ie, screening and brief intervention) and treatment of alcohol use disorders (AUD). Data were collected regarding whether EHRs included these features.

Results: EHRs from 21 vendors were used by the primary care practices. For prevention, 62% of the 167 practices' EHRs included a validated screening questionnaire, 46% automatically scored the screening instrument, 62% could report the percent screened, and 37% could report the percent screening positive. Only 7% could report the percent offered brief intervention. For alcohol treatment, 49% of practices could report the percent diagnosed with AUD, 58% and 91% allowed documentation of referral and treatment with AUD medication, respectively. Only 3% could report the percent of patients diagnosed with AUD who received treatment.

Discussion: Most EHRs observed across 167 primary care practices across 7 US states lacked basic functionality necessary to support evidence-based alcohol-related prevention and AUD treatment. Only 3% and 7% of EHRs, respectively, included the ability to report widely recommended quality measures needed to improve the quality of recommended alcohol-related prevention and treatment in primary care.

Conclusion: Improving EHR functionality is likely necessary before alcohol-related primary care can be improved.

初级保健实践使用的电子健康记录是否支持推荐的酒精相关护理?
目的:美国初级保健中酒精相关预防和治疗的质量较差。本研究的目的是描述目前7个州167个初级保健实践使用的电子健康记录(EHRs)在多大程度上包括必要的提示、临床支持和绩效报告,这些都是改善初级保健中与酒精相关的预防和治疗所必需的。材料和方法:来自五个区域质量改进项目的专家确定了支持基于证据的酒精相关预防(即筛查和短暂干预)和治疗酒精使用障碍(AUD)所需的基本电子病历特征。收集了关于电子病历是否包括这些特征的数据。结果:21家供应商的电子病历被用于初级保健实践。在预防方面,167个实践中有62%的电子病历包括有效的筛查问卷,46%的人自动对筛查工具进行评分,62%的人可以报告筛查的百分比,37%的人可以报告筛查阳性的百分比。只有7%的人可以报告提供短暂干预的百分比。对于酒精治疗,49%的实践可以报告诊断为AUD的百分比,58%和91%分别允许转诊和使用AUD药物治疗的记录。只有3%的人可以报告诊断为AUD的患者接受治疗的百分比。讨论:在美国7个州167个初级保健实践中观察到的大多数电子病历缺乏支持基于证据的酒精相关预防和AUD治疗所需的基本功能。分别只有3%和7%的电子病历包括报告广泛推荐的质量措施的能力,这些措施是提高初级保健中推荐的酒精相关预防和治疗质量所必需的。结论:在改善与酒精相关的初级保健之前,可能有必要改善电子病历功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAMIA Open
JAMIA Open Medicine-Health Informatics
CiteScore
4.10
自引率
4.80%
发文量
102
审稿时长
16 weeks
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