title: "Salt in the Wound": Safety Net Clinician Perspectives on Performance Feedback Derived From EHR Data.
abstract: Electronic health record (EHR) data can be extracted for calculating performance feedback, but users' perceptions of such feedback impact its effectiveness. Through qualitative analyses, we identified perspectives on barriers and facilitators to the perceived legitimacy of EHR-based performance feedback, in 11 community health centers (CHCs). Providers said such measures rarely accounted for CHC patients' complex lives or for providers' decisions as informed by this complexity, which diminished the measures' perceived validity. Suggestions for improving the perceived validity of performance feedback in CHCs are presented. Our findings add to the literature on EHR-based performance feedback by exploring provider perceptions in CHCs.
authors.affiliation: Kaiser Permanente Center for Health Research, Portland, Oregon (Mss Bunce and Hollombe, Dr Gold, and Mr Davis); OCHIN, Inc, Portland, Oregon (Drs Gold and Nelson); Virginia Garcia Memorial Health Center, Cornelius, Oregon (Ms Mercer); and Multnomah County Health Department, Portland, Oregon (Ms Jaworski).
authors.forename: Arwen E
authors.initials: AE
authors.lastname: Bunce
authors.forename: Rachel
authors.initials: R
authors.lastname: Gold
authors.forename: James V
authors.initials: JV
authors.lastname: Davis
authors.forename: MaryBeth
authors.initials: M
authors.lastname: Mercer
authors.forename: Victoria
authors.initials: V
authors.lastname: Jaworski
authors.forename: Celine
authors.initials: C
authors.lastname: Hollombe
authors.forename: Christine
authors.initials: C
authors.lastname: Nelson
mesh_terms: D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D003151:Community Health Centers / Q000458:organization & administration / Q000592:standards*; D048909:Diabetes Complications / Q000517:prevention & control*; D057286:Electronic Health Records / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D055317:Evidence-Based Practice / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005246:Feedback; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D017060:Patient Satisfaction; D036301:Qualitative Research; D064876:Safety-net Providers / Q000458:organization & administration / Q000592:standards*; D000078329:Workforce
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors