The National Committee for Quality Assurance (NCQA), the American Academy of Family Physicians National Research Network (AAFP NRN), and New York City Department of Health and Mental Hygiene have joined in this proposal to address critical policy questions regarding the feasibility, clinical acceptance, and measurability of MU Stage 3 objectives. Our long-term goal is to demonstrate how meaningful use of health IT can contribute to achievement of the National Quality Strategy goals of better care, healthy people and communities, and affordable care. This project will examine the feasibility, measurability and clinical relevance of six proposed MU Stage 3 objectives related to care coordination, including reconciliation and tracking of referrals, care transition record, and use of information for patient engagement and clinical decision-making.
Our specific aims are Aim 1 To assess the technical feasibility and clinical acceptance of the proposed MU Stage 3 objectives for care coordination in diverse practice settings, Aim 2 to identify organizational and contextual factors that distinguish practices with a higher versus lower level of implementation of EHR functionality and clinical workflows for care coordination envisioned by the proposed MU Stage 3 objectives, and Aim 3 to explore methods for measuring and reporting on implementation of the proposed MU Stage 3 Objectives. This mixed-methods study will include a survey of 300 diverse practices to understand current implementation of care coordination activities in EHR functionality and clinical workflows, interviews of 20 practices that have implemented care coordination workflows with and without EHR functionality, and case studies of 10 practices that have adopted health IT capabilities for aspects of care coordination that are relevant to with the proposed objectives. We will vet the results and technical recommendations through review with a panel of EHR vendors. We will use the results of this project to provide our federal government a roadmap to achievement of the proposed MU objectives and how to measure their achievement by providers in ambulatory care settings. At the end of this 12-month project, we will have developed and disseminated 1) recommendations for potential revisions to the proposed MU Stage 3 objectives and to the proposed measures, 2) recommendations for changes in EHR certification criteria, and 3) examples of successful workflows and information on barriers to implementation. In addition to a report for federal policymakers, we will develop dissemination materials appropriate for primary care and specialty practices and disseminate these widely through NCQA's educational programs for providers and health plans, through AAFP educational channels, and in collaboration with AHRQ.

Public Health Relevance

The National Committee for Quality Assurance, the American Academy of Family Physicians National Research Network, and the New York City Department of Health and Mental Hygiene propose a mixed- methods study to examine the feasibility, clinical acceptance, and measurability of six proposed Meaningful Use (MU) Stage 3 objectives related to care coordination, including referral management, informed care transitions, and use of information for patient engagement and clinical decision-making. We will conduct a survey of 300 diverse practices to understand current workflow and use of EHR technology in care coordination activities, interviews of 20 practices that have implemented care coordination activities with and without EHR functionality, and case studies of 10 practices that have adopted EHR technology in the activities represented by the proposed MU objectives. At the end of this 12-month project, we will have developed and disseminated 1) recommendations for potential revisions to the proposed MU Stage 3 objectives and to the proposed measures, 2) recommendations for changes in EHR certification criteria, and 3) examples of successful workflows and information on barriers to successful implementation.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS022693-01
Application #
8642605
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Roper, Rebecca
Project Start
2013-09-30
Project End
2014-09-29
Budget Start
2013-09-30
Budget End
2014-09-29
Support Year
1
Fiscal Year
2013
Total Cost
Indirect Cost
Name
National Committee for Quality Assurance
Department
Type
DUNS #
611354523
City
Washington
State
DC
Country
United States
Zip Code
20005