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Effect on VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records.
J Gen Intern Med. 2019 01; 34(1):132-136.JG

Abstract

PURPOSE

To examine associations between patient perceptions that their provider was knowledgeable of their medical history and clinicians' early adoption of an application that presents providers with an integrated longitudinal view of a patient's electronic health records (EHR) from multiple healthcare systems.

METHOD

This retrospective analysis utilizes provider audit logs from the Veterans Health Administration Joint Legacy Viewer (JLV) and patient responses to the Survey of Patient Healthcare Experiences Patient-Centered Medical Home (SHEP/PCMH) patient satisfaction survey (FY2016) to assess the relationship between the primary care provider being an early adopter of JLV and patient perception of the provider's knowledge of their medical history. Multivariate logistic regression models were used to control for patient age, race, sex education, health status, duration of patient-provider relationship, and provider characteristics.

RESULTS

The study used responses from 203,903 patients to the SHEP-PCMH survey in FY2016 who received outpatient primary care services from 11,421 unique providers. Most (91%) clinicians had no JLV utilization in the 6 months prior to the studied patient visit. Controlling for patient demographics, length of the patient-provider relationship, and provider and facility characteristics, being an early adopter of the JLV system was associated with a 14% (adj OR 1.14, p < 0.000) increased odds that patients felt their provider was knowledgeable about their medical history. When evaluating the interaction between duration of patient-provider relationship and being an early adopter of JLV, a greater effect was seen with patient-provider relationships that were greater than 3 years (adj OR 1.23, p < 0.000), compared to those less than 3 years.

CONCLUSIONS

Increasing the interoperability of medical information systems has the potential to improve both patient care and patient experience of care. This study demonstrates that early adopters of an integrated view of electronic health records from multiple delivery systems are more likely to have their patients report that their clinician was knowledgeable of their medical history. With provider payments often linked to patient satisfaction performance metrics, investments in interoperability may be worthwhile.

Authors+Show Affiliations

Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA, USA.Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA, USA.Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA, USA.Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA. Geriatric Research and Education Clinical Center, VA Salt Lake City Health Care System, US Department of Veterans Affairs, Salt Lake City, UT, USA. Office of Health Informatics, US Department of Veterans Affairs, Los Angeles, CA, USA.Office of Health Informatics, US Department of Veterans Affairs, Los Angeles, CA, USA.Office of Health Informatics, US Department of Veterans Affairs, Los Angeles, CA, USA.Partnered Evidence-Based Policy Resource Center, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA, USA. pizer@bu.edu. Department of Health Law, Policy, and Management, Boston University School of Public Health, 715 Albany Street, Talbot 247 W, Boston, MA, 02118, USA. pizer@bu.edu.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30338474

Citation

Legler, Aaron, et al. "Effect On VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records." Journal of General Internal Medicine, vol. 34, no. 1, 2019, pp. 132-136.
Legler A, Price M, Parikh M, et al. Effect on VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records. J Gen Intern Med. 2019;34(1):132-136.
Legler, A., Price, M., Parikh, M., Nebeker, J. R., Ward, M. C., Wedemeyer, L., & Pizer, S. D. (2019). Effect on VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records. Journal of General Internal Medicine, 34(1), 132-136. https://doi.org/10.1007/s11606-018-4708-z
Legler A, et al. Effect On VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records. J Gen Intern Med. 2019;34(1):132-136. PubMed PMID: 30338474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect on VA Patient Satisfaction of Provider's Use of an Integrated Viewer of Multiple Electronic Health Records. AU - Legler,Aaron, AU - Price,Megan, AU - Parikh,Megha, AU - Nebeker,Jonathan R, AU - Ward,Merry C, AU - Wedemeyer,Linda, AU - Pizer,Steven D, Y1 - 2018/10/18/ PY - 2017/12/17/received PY - 2018/10/01/accepted PY - 2018/04/25/revised PY - 2018/10/20/pubmed PY - 2020/4/21/medline PY - 2018/10/20/entrez KW - electronic health record (EHR) KW - electronic medical record (EMR) KW - health information exchange (HIE) KW - health information technology (HIT) KW - interoperability KW - patient satisfaction SP - 132 EP - 136 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 34 IS - 1 N2 - PURPOSE: To examine associations between patient perceptions that their provider was knowledgeable of their medical history and clinicians' early adoption of an application that presents providers with an integrated longitudinal view of a patient's electronic health records (EHR) from multiple healthcare systems. METHOD: This retrospective analysis utilizes provider audit logs from the Veterans Health Administration Joint Legacy Viewer (JLV) and patient responses to the Survey of Patient Healthcare Experiences Patient-Centered Medical Home (SHEP/PCMH) patient satisfaction survey (FY2016) to assess the relationship between the primary care provider being an early adopter of JLV and patient perception of the provider's knowledge of their medical history. Multivariate logistic regression models were used to control for patient age, race, sex education, health status, duration of patient-provider relationship, and provider characteristics. RESULTS: The study used responses from 203,903 patients to the SHEP-PCMH survey in FY2016 who received outpatient primary care services from 11,421 unique providers. Most (91%) clinicians had no JLV utilization in the 6 months prior to the studied patient visit. Controlling for patient demographics, length of the patient-provider relationship, and provider and facility characteristics, being an early adopter of the JLV system was associated with a 14% (adj OR 1.14, p < 0.000) increased odds that patients felt their provider was knowledgeable about their medical history. When evaluating the interaction between duration of patient-provider relationship and being an early adopter of JLV, a greater effect was seen with patient-provider relationships that were greater than 3 years (adj OR 1.23, p < 0.000), compared to those less than 3 years. CONCLUSIONS: Increasing the interoperability of medical information systems has the potential to improve both patient care and patient experience of care. This study demonstrates that early adopters of an integrated view of electronic health records from multiple delivery systems are more likely to have their patients report that their clinician was knowledgeable of their medical history. With provider payments often linked to patient satisfaction performance metrics, investments in interoperability may be worthwhile. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/30338474/Effect_on_VA_Patient_Satisfaction_of_Provider's_Use_of_an_Integrated_Viewer_of_Multiple_Electronic_Health_Records_ L2 - https://dx.doi.org/10.1007/s11606-018-4708-z DB - PRIME DP - Unbound Medicine ER -