Varied rates of implementation of patient-centered medical home features and residents’ perceptions of their importance based on practice experience

M (Patrice) Eiff, Larry A. Green, Geoff Jones, Alex Verdieck Devlaeminck, Elaine Waller, Eve Dexter, Miguel Marino, Patricia (Patty) Carney

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. RESULTS: Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33% to 67%), preventive services registries (23% to 64%), chronic disease registries (63% to 82%), and population-based quality assurance (46% to 79%). Team-based care was the only process of care feature to change significantly (54% to 93%). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. CONCLUSIONS: Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.

Original languageEnglish (US)
Pages (from-to)183-192
Number of pages10
JournalFamily Medicine
Volume49
Issue number3
StatePublished - Mar 1 2017

Fingerprint

Patient-Centered Care
Internship and Residency
Electronic Health Records
Registries
Chronic Disease
Logistic Models
Communication
Medicine
Population

ASJC Scopus subject areas

  • Family Practice

Cite this

Varied rates of implementation of patient-centered medical home features and residents’ perceptions of their importance based on practice experience. / Eiff, M (Patrice); Green, Larry A.; Jones, Geoff; Devlaeminck, Alex Verdieck; Waller, Elaine; Dexter, Eve; Marino, Miguel; Carney, Patricia (Patty).

In: Family Medicine, Vol. 49, No. 3, 01.03.2017, p. 183-192.

Research output: Contribution to journalArticle

@article{f38c4cee71cc42c2a8da9f009796ce31,
title = "Varied rates of implementation of patient-centered medical home features and residents’ perceptions of their importance based on practice experience",
abstract = "BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. RESULTS: Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33{\%} to 67{\%}), preventive services registries (23{\%} to 64{\%}), chronic disease registries (63{\%} to 82{\%}), and population-based quality assurance (46{\%} to 79{\%}). Team-based care was the only process of care feature to change significantly (54{\%} to 93{\%}). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. CONCLUSIONS: Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.",
author = "Eiff, {M (Patrice)} and Green, {Larry A.} and Geoff Jones and Devlaeminck, {Alex Verdieck} and Elaine Waller and Eve Dexter and Miguel Marino and Carney, {Patricia (Patty)}",
year = "2017",
month = "3",
day = "1",
language = "English (US)",
volume = "49",
pages = "183--192",
journal = "Family Medicine",
issn = "0742-3225",
publisher = "Society of Teachers of Family Medicine",
number = "3",

}

TY - JOUR

T1 - Varied rates of implementation of patient-centered medical home features and residents’ perceptions of their importance based on practice experience

AU - Eiff, M (Patrice)

AU - Green, Larry A.

AU - Jones, Geoff

AU - Devlaeminck, Alex Verdieck

AU - Waller, Elaine

AU - Dexter, Eve

AU - Marino, Miguel

AU - Carney, Patricia (Patty)

PY - 2017/3/1

Y1 - 2017/3/1

N2 - BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. RESULTS: Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33% to 67%), preventive services registries (23% to 64%), chronic disease registries (63% to 82%), and population-based quality assurance (46% to 79%). Team-based care was the only process of care feature to change significantly (54% to 93%). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. CONCLUSIONS: Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.

AB - BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features. Annual resident surveys (n=690) assessed perceptions of importance of PCMH features using a 4-point scale (not at all important to very important). We used generalized estimating equations logistic regression to assess trends and ordinal-response proportional odds regression models to determine if resident ratings of importance were associated with working with those features during training. RESULTS: Implementation of electronic health record (EHR) features increased significantly from 2007-2011, such as email communication with patients (33% to 67%), preventive services registries (23% to 64%), chronic disease registries (63% to 82%), and population-based quality assurance (46% to 79%). Team-based care was the only process of care feature to change significantly (54% to 93%). Residents with any exposure to EHR-based features had higher odds of rating the features more important compared to those with no exposure. We observed consistently lower odds of the resident rating process of care features as more important with any exposure compared to no exposure. CONCLUSIONS: Residencies engaged in educational transformation were more successful in implementing EHR-based PCMH features, and exposure during training appears to positively influence resident ratings of importance, while exposure to process of care features are slower to implement with less influence on importance ratings.

UR - http://www.scopus.com/inward/record.url?scp=85016048585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016048585&partnerID=8YFLogxK

M3 - Article

C2 - 28346620

AN - SCOPUS:85016048585

VL - 49

SP - 183

EP - 192

JO - Family Medicine

JF - Family Medicine

SN - 0742-3225

IS - 3

ER -