title: Small practices' experience with EHR, quality measurement, and incentives.
abstract: OBJECTIVE
  To assess clinician attitudes and experiences in Health eHearts, a quality recognition and financial incentive program using health information technology.
  
  
  METHODS
  Survey of physicians.
  
  
  METHODS
  A survey was administered to 140 lead clinicians at each participating practice. Survey domains included clinicians' experiences and attitudes toward the selected clinical quality measures focused on cardiovascular care, use of electronic health records (EHRs), technical assistance visits, quality measurement reports, and incentive payments. Responses were compared across groups of practices receiving financial incentives with those in the control (no financial rewards).
  
  
  RESULTS
  Survey response rate was 74%. The majority of respondents reported receiving and reviewing the quality reports (89%), agreed with the prioritization of measures (89%), and understood the information given in the quality reports (95%). Over half of the respondents had a quality improvement visit (56%), with incentive clinicians more likely to have had a visit compared with the control group (68% vs 43%, P = .01). The incentive group respondents (92%) were more likely to report using clinical decision support system alerts than control group respondents (82%, P = .11).
  
  
  CONCLUSIONS
  Clinicians in both incentive and control groups reported positive experiences with the program. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population. However, clinicians in the incentive group were more likely to review quarterly performance reports and access quality improvement visits. Incentives may be used to further engage clinicians operating in small independently owned practices to participate in quality improvement activities.
authors: Rohima
authors: R
authors: Begum
authors: Mandy
authors: M
authors: Smith Ryan
authors: Chloe H
authors: CH
authors: Winther
authors: Jason J
authors: JJ
authors: Wang
authors: Naomi S
authors: NS
authors: Bardach
authors: Amanda H
authors: AH
authors: Parsons
authors: New York City Department of Health and Mental Hygiene, Primary Care Information Project, 42-09 28th St, 12th Fl, Queens, NY 11101. E-mail: sshih@health.nyc.gov.
authors: Sarah C
authors: SC
authors: Shih
authors: R Adams
authors: RA
authors: Dudley
mesh_terms: D001291:Attitude of Health Personnel; D057286:Electronic Health Records; D006801:Humans; D009519:New York City; D011216:Practice Management, Medical; D011320:Primary Health Care / Q000458:organization & administration; D058996:Quality Improvement; D012052:Reimbursement, Incentive; D011795:Surveys and Questionnaires