Transforming the Office Management of Heart Failure using the Chronic Disease Model in a Residenc
1. Information Technology
in PBRN Practices
Survey vs. Site Visit
Donald E. Nease, Jr, Lee A. Green, Aartee Ignazcek,
Patricia Watkins, John Calcagni, Gabe Thompson
University of Michigan
Department of Family Medicine
Funded by: AHRQ R03 HS14413
2. why IT & PBRNs?
• practice electronic data
• demographics, diagnoses, services
• availability of internet access
• communication, distribution & return of
study related information & materials
• collection of data via web
Pace WD, Staton EW. Electronic data collection options for practice-based
research networks. Ann Fam Med. 2005 May-Jun;3 Suppl 1:S21-9.
3. prior work
• Andrews, et. al., 2004
• Kentucky Ambulatory Network (KAN)
• mailed survey of 68 office managers & 116
clinicians (46% & 51% resp. rate)
• 100% using electronic billing
• 50% have a LAN; internet in all but one
• 94% electronic scheduling
• 21% with an EMR
Andrews JE, Pearce KA, Sydney C, Ireson C, Love M. Current state of information technology use in a
US primary care practice-based research network. Inform Prim Care. 2004;12(1):11-8.
4.
5. GRIPS
GRIN Research Infrastructure Practice Survey
• Aim: Conduct on-site detailed structural and
functional assessments of GRIN practices focused
on:
• current use of information systems
• billing
• electronic medical records
• reminder systems
• internet
6. methods
• Pre-visit survey - immediately prior to visit
• Visit
• Interviews with office manager, clinicians
& staff
• Detailed observations
• Post-visit report
• Did we get it right?
7. GRIPS so far
• 33 surveyed & visited (target = 50)
• 85% have no academic affiliation
• Mean # physicians - 3.5 (2.8)
• Mean # extenders - 1.3 (0.9) among those
who have them
8. results - connectivity
yes no yes no
100%
97%
87%
75%
41%
50%
59%
25%
13%
0% 3%
survey visit
are your computers networked? internet access at all workstations?
9. results - office systems
yes no
•
100% 50% of those
checking “no” on
87%
83%
75% the survey actually
do
50%
• One practice that
25%
checked “yes” on
17%
13%
the survey actually
0%
does not
survey visit
do you utilize computerized billing?
10. results - office systems
yes no yes no
100%
94% 94%
75%
50% 29%
71%
25%
0% 6% 6%
survey visit
do you utilize computerized scheduling? computerized demographic reports?
11. results - office systems
yes no yes no
100%
20%
75%
73% 70%
50%
25% 30%
27%
80%
0%
survey visit
do you utilize an EMR? use an EMR beyond basic charting?
12. results - IT support
internal external yes no
100%
93%
75%
67%
42%
50%
58%
33%
25%
0% 7%
survey visit
IT staff internal or external is IT support externally contracted?
13. conclusions
• GRIN PBRN practices
visited so far...
• IT infrastructure
limited to basic office
systems
• may not be useful for
enabling research
• Survey data alone may
not give an accurate
picture
