Abstract
Development of task-specific electronic medical record (EMR) searches and user interfaces has the potential to improve the efficiency and safety of health care while curbing rising costs. The development of such tools must be data-driven and guided by a strong understanding of practitioner information requirements with respect to specific clinical tasks or scenarios. To acquire this important data, this paper describes a model by which expert practitioners are leveraged to identify which components of the medical record are most relevant to a specific clinical task. We also describe the computer system that was created to efficiently implement this model of data gathering. The system extracts medical record data from the EMR of patients matching a given clinical scenario, de-identifies the data, breaks the data up into separate medical record items (eg, radiology reports, operative notes, laboratory results, etc), presents each individual medical record item to experts under the hypothetical of the given clinical scenario, and records the experts’ ratings regarding the relevance of each medical record item to that specific clinical scenario or task. After an iterative process of data collection, these expert relevance ratings can then be pooled and used to design point-of-care EMR searches and user interfaces tailored to the task-specific needs of practitioners.
Highlights
In 2011, 52% of physicians reported intending to apply for the Medicare or Medicaid EHR incentive payments, a 26% increase from 2010
43% of physicians planning to apply for incentives had EHR systems with functions that would allow them to meet eight Stage 1 Core Set meaningful use objectives
In 2010, the percentage of physicians planning to apply for incentives with EHR systems able to support eight Stage 1 Core Set objectives exceeded the national average in eight states (Iowa, Maine, Massachusetts, Minnesota, Oregon, Utah, Washington, and Wisconsin) and was below the national average only in Texas
Summary
In 2011, 57% of office-based physicians used electronic medical record/electronic health record (EMR/EHR) systems, with use by state ranging from 40% in Louisiana to 84% in North Dakota. In 2010, 43% of physicians planning to apply for meaningful use incentives had computerized systems that would allow them to meet eight Stage 1 Core Set objectives, with percentages by state ranging from 26% in Texas to 70% in Wisconsin. Eligible Medicare and Medicaid physicians may receive incentive payments over 5 years if they demonstrate 15 Stage 1 Core Set objectives and 5 of 10 Menu Set objectives, using certified EHR systems. This report describes trends in adoption of electronic medical record/electronic health record (EMR/ EHR) systems through 2011 and provides baseline information on physician readiness to meet eight Stage 1 Core “meaningful use” objectives in 2010 (see “Definitions” section for an overview of meaningful use objectives). Adoption of EMR/EHR systems by office-based physicians has increased
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