Delivering person-centered care with an electronic health record
Abstract Background Electronic 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 electroni...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Medical Informatics and Decision Making |
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| Online Access: | http://link.springer.com/article/10.1186/s12911-019-0897-6 |
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| author | Victoria Stanhope Elizabeth B. Matthews |
| author_facet | Victoria Stanhope Elizabeth B. Matthews |
| author_sort | Victoria Stanhope |
| collection | DOAJ |
| description | Abstract Background Electronic 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. Methods The 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. Results All 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. Conclusions The 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 registration Clinicaltrials.gov, NCT02299492, registered on November 24, 2014. |
| first_indexed | 2024-12-23T11:21:44Z |
| format | Article |
| id | doaj.art-73aaf96139a64d68920b08a595d720b5 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-23T11:21:44Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-73aaf96139a64d68920b08a595d720b52022-12-21T17:49:04ZengBMCBMC Medical Informatics and Decision Making1472-69472019-08-011911910.1186/s12911-019-0897-6Delivering person-centered care with an electronic health recordVictoria Stanhope0Elizabeth B. Matthews1Silver School of Social Work, New York UniversityGraduate School of Service, Fordham UniversityAbstract Background Electronic 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. Methods The 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. Results All 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. Conclusions The 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 registration Clinicaltrials.gov, NCT02299492, registered on November 24, 2014.http://link.springer.com/article/10.1186/s12911-019-0897-6Person-centered careElectronic health recordsHealth information technologyMental health services |
| spellingShingle | Victoria Stanhope Elizabeth B. Matthews Delivering person-centered care with an electronic health record BMC Medical Informatics and Decision Making Person-centered care Electronic health records Health information technology Mental health services |
| title | Delivering person-centered care with an electronic health record |
| title_full | Delivering person-centered care with an electronic health record |
| title_fullStr | Delivering person-centered care with an electronic health record |
| title_full_unstemmed | Delivering person-centered care with an electronic health record |
| title_short | Delivering person-centered care with an electronic health record |
| title_sort | delivering person centered care with an electronic health record |
| topic | Person-centered care Electronic health records Health information technology Mental health services |
| url | http://link.springer.com/article/10.1186/s12911-019-0897-6 |
| work_keys_str_mv | AT victoriastanhope deliveringpersoncenteredcarewithanelectronichealthrecord AT elizabethbmatthews deliveringpersoncenteredcarewithanelectronichealthrecord |