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| Name | Class |
|---|---|
| New York State Department of Health | OTHER_GOV |
| The Commonwealth Fund | OTHER |
| Taconic Health Information Network and Community (THINC) | UNKNOWN |
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The investigators will conduct a longitudinal cohort study with concurrent controls. The investigators will include all primary care physicians in the Hudson Valley including family practitioners, internists, and pediatricians. The purpose of this study is to determine the effects of implementing electronic health records (EHRs), pay-for-performance incentives for physicians (P4P), and Medical Home redesign on health care quality, cost and patient experience in the Hudson Valley.
The Hudson Valley is implementing several innovative programs to potentially improve quality and reduce the cost of health care delivered. First the Taconic Health Information Network and Communities Regional Health Information Organization (THINC RHIO) is facilitating diffusion of EHRs in office practices in the Hudson Valley. Second, THINC RHIO is also offering a strategic approach to pay-for-performance. Third, an additional component of the THINC P4P project will be an added financial incentive for private practice physicians who implement and reach Level II of Physician Practice Connections® - Patient Centered Medical Home (PCMH)™, NCQA's new national recognition system for physician practices. Our study will seek to determine the effect of each of these initiatives on health care quality and cost of care in the Hudson Valley. We will also measure the patient experience before and after implementation of the Medical Home.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | Physicians that are using paper-based medical charts and who are not receiving Medical Home redesign incentives. | ||
| 2 | Physicians that are using Electronic Health Records (EHRs) and who are not undergoing Medical Home redesign. |
| |
| 3 | Physicians that are using Electronic Health Records (EHRs) and undergoing Medical Home redesign. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electronic health record (EHR) | Other | Computer-based system that allows physicians to access and manage patient records electronically. |
|
| Measure | Description | Time Frame |
|---|---|---|
| health care quality (as determined by previously selected and approved quality indicators) | 5 years | |
| health care utilization | 5 years |
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Inclusion Criteria:
Exclusion Criteria:
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All primary care physicians (i.e. general internists, pediatricians and family practice physicians) in the Hudson Valley who are members of the Taconic Independent Practice Association (IPA).
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| Name | Affiliation | Role |
|---|---|---|
| Lisa M Kern, MD, MPH | Weill Medical College of Cornell University | Principal Investigator |
| Rainu Kaushal, MD, MPH | Weill Medical College of Cornell University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Weill Cornell Medical College | New York | New York | 10021 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26882534 | Derived | Kern LM, Edwards A, Kaushal R. The Patient-Centered Medical Home and Associations With Health Care Quality and Utilization: A 5-Year Cohort Study. Ann Intern Med. 2016 Mar 15;164(6):395-405. doi: 10.7326/M14-2633. Epub 2016 Feb 16. | |
| 25848412 | Derived | Kaushal R, Edwards A, Kern LM; HITEC Investigators. Association between electronic health records and health care utilization. Appl Clin Inform. 2015 Jan 28;6(1):42-55. doi: 10.4338/ACI-2014-10-RA-0089. eCollection 2015. |
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| ID | Term |
|---|---|
| D057286 | Electronic Health Records |
| ID | Term |
|---|---|
| D016347 | Medical Records Systems, Computerized |
| D008499 | Medical Records |
| D011996 | Records |
| D003625 | Data Collection |
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| Taconic Independent Practice Association (TIPA) |
| UNKNOWN |
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| Medical Home redesign | Other | Implementation of NCQA Level III Medical Home |
|
| 24887615 | Derived | Kern LM, Edwards A, Kaushal R. The patient-centered medical home, electronic health records, and quality of care. Ann Intern Med. 2014 Jun 3;160(11):741-9. doi: 10.7326/M13-1798. |
| D004812 |
| Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |