Abstract
BackgroundElectronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics.MethodsThe study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record.ResultsAll clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds.ConclusionsThe study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care.Trial registrationClinicaltrials.gov, NCT02299492, registered on November 24, 2014.
Highlights
Electronic health records (EHRs) have great potential to improve the quality of care by promoting effectiveness, efficiency, timely, patient-centered care, safety and equity [1, 2]
This digital technology has become a key strategy in health care reform efforts with the EHR adoption by health care organizations being incentivized by policies such as the Affordable Care Act and the Health Information Technology for Economic and Clinical Health Act
While the majority of the research on EHRs has been in medical settings, this study focuses on how they influence the delivery of person-centered care in behavioral health settings
Summary
Electronic health records (EHRs) have great potential to improve the quality of care by promoting effectiveness, efficiency, timely, patient-centered care, safety and equity [1, 2]. There is evidence showing how EHRs can be a detriment to health care delivery due to disruptions in workflow, provider resistance and lack of compatibility with existing health practices [5]. This has led to calls for research examining the “black box” of EHR adoption to fully understand how adoption and sustainment influences clinical practice. Electronic health records are widely adopted in medical and behavioral health settings While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
