title: The Path to Quality in Outpatient Practice: Meaningful Use, Patient-Centered Medical Homes, Financial Incentives, and Technical Assistance.
abstract: Adoption and meaningful use of electronic health records is considered an essential step to improve the quality of health care. The authors assessed whether a series of Connecticut primary care providers who achieved Stage I Meaningful Use of electronic health records used quality improvement strategies that are associated with improvements in care. Practice structural characteristics, quality improvement-related electronic health record processes, outcomes, and barriers were assessed in 14 primary care practices. Implementation of quality improvement-related electronic health record processes was variable and barriers were common. Only 4 practices used data consistently to assess their performance, and only 3 reported improvements in care. Practices that were patient-centered medical homes scored higher on all quality improvement domains and received financial rewards more commonly. These findings suggest that primary care quality may be improved by formal alignment of Meaningful Use and Patient-Centered Medical Home criteria and by ongoing technical assistance to practices.
authors.affiliation: Qualidigm, Wethersfield, CT Yale University School of Medicine, New Haven, CT tmeehan@qualidigm.org.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Meehan
authors.affiliation: Qualidigm, Wethersfield, CT.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Meehan
authors.affiliation: Qualidigm, Wethersfield, CT.
authors.forename: Michele
authors.initials: M
authors.lastname: Kelvey-Albert
authors.affiliation: Qualidigm, Wethersfield, CT University of Connecticut School of Nursing, Storrs, CT University of Connecticut School of Medicine, Farmington, CT.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Van Hoof
authors.affiliation: eHealthConnecticut, Hartford, CT.
authors.forename: Steve
authors.initials: S
authors.lastname: Ruth
authors.affiliation: Qualidigm, Wethersfield, CT.
authors.forename: Marcia K
authors.initials: MK
authors.lastname: Petrillo
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration* / Q000592:standards; D057286:Electronic Health Records; D006801:Humans; D062527:Meaningful Use / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012052:Reimbursement, Incentive / Q000458:organization & administration
keywords: meaningful use; patient-centered medical home; primary care; quality improvement