title: Using multi-stakeholder alliances to accelerate the adoption of health information technology by physician practices.
abstract: BACKGROUND
  Multi-stakeholder alliances - groups of payers, purchasers, providers, and consumers that work together to address local health goals - are frequently used to improve health care quality within communities. Under the Aligning Forces for Quality (AF4Q) initiative, multi-stakeholder alliances were given funding and technical assistance to encourage the use of health information technology (HIT) to improve quality. We investigated whether HIT adoption was greater in AF4Q communities than in other communities.
  
  
  METHODS
  Drawing upon survey data from 782 small and medium-sized physician practices collected as part of the National Study of Physician Organizations during July 2007 - March 2009 and January 2012-November 2013, we used weighted fixed effects models to detect relative changes in four measures representing three domains: use of electronic health records (EHRs), receipt of electronic information from hospitals, and patients' online access to their medical records.
  
  
  RESULTS
  Improvement on a composite EHR adoption measure was 7.6 percentage points greater in AF4Q communities than in non-AF4Q communities, and the increase in the probability of adopting all five EHR capabilities was 23.9 percentage points greater in AF4Q communities. There was no significant difference in improvement in receipt of electronic information from hospitals or patients' online access to medical records between AF4Q and non-AF4Q communities.
  
  
  CONCLUSIONS
  By linking HIT to quality improvement efforts, AF4Q alliances may have facilitated greater adoption of EHRs in small and medium-sized physician practices, but not receipt of electronic information from hospitals or patients' online access to medical records.
  
  
  CONCLUSIONS
  Multi-stakeholder alliances charged with promoting HIT to advance quality improvement may accelerate adoption of EHRs.
authors.affiliation: Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University, Feinberg School of Medicine, 633 N. Saint Clair 20th Floor Chicago, IL 60611, USA. Electronic address: megan-mchugh@northwestern.edu.
authors.forename: Megan
authors.initials: M
authors.lastname: McHugh
authors.affiliation: Department of Health Policy and Administration, Center for Health Care Policy and Research, The Pennsylvania State University, 504Q Donald H. Ford Building University Park, PA 16802, United States. Electronic address: Yus16@psu.edu.
authors.forename: Yunfeng
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Abt Associates, 55 Wheeler St., Cambridge, MA 02138, United States. Electronic address: sean_mcclellan@abtassoc.com.
authors.forename: Sean R
authors.initials: SR
authors.lastname: McClellan
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA, United States. Electronic address: shortell@berkeley.edu.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Shortell
authors.affiliation: Department of Health Policy and Administration Center for Health Care Policy and Research, The Pennsylvania State University, 504U Donald H. Ford Building, University Park, PA 16802, United States. Electronic address: fareedn@psu.edu.
authors.forename: Naleef
authors.initials: N
authors.lastname: Fareed
authors.affiliation: Medical University of South Carolina, College of Health Professions, 151B Rutledge Avenue, B409 Charleston, SC 29425, United States. Electronic address: harveyji@musc.edu.
authors.forename: Jillian
authors.initials: J
authors.lastname: Harvey
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA, United States. Electronic address: pramsay@berkeley.edu.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ramsay
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, 402 East 67th Street, LA-217, New York, NY, USA. Electronic address: lac2021@med.cornell.edu.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Casalino
mesh_terms: D003299:Cooperative Behavior; D057286:Electronic Health Records / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007373:Interinstitutional Relations; D008490:Medical Informatics / Q000191:economics / Q000458:organization & administration*; D015999:Multivariate Analysis; D009936:Organizational Innovation; D010820:Physicians; D058996:Quality Improvement; D014481:United States