Evaluating the Effects of EHRs, P4P and Medical Home Redesign in the Hudson Valley

NCT ID: NCT00793065

Last Updated: 2017-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

438 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-01-31

Study Completion Date

2012-12-31

Brief Summary

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The investigators will conduct a longitudinal cohort study with concurrent controls. The investigators will include all primary care physicians in the Hudson Valley including family practitioners, internists, and pediatricians. The purpose of this study is to determine the effects of implementing electronic health records (EHRs), pay-for-performance incentives for physicians (P4P), and Medical Home redesign on health care quality, cost and patient experience in the Hudson Valley.

Detailed Description

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The Hudson Valley is implementing several innovative programs to potentially improve quality and reduce the cost of health care delivered. First the Taconic Health Information Network and Communities Regional Health Information Organization (THINC RHIO) is facilitating diffusion of EHRs in office practices in the Hudson Valley. Second, THINC RHIO is also offering a strategic approach to pay-for-performance. Third, an additional component of the THINC P4P project will be an added financial incentive for private practice physicians who implement and reach Level II of Physician Practice Connections® - Patient Centered Medical Home (PCMH)™, NCQA's new national recognition system for physician practices. Our study will seek to determine the effect of each of these initiatives on health care quality and cost of care in the Hudson Valley. We will also measure the patient experience before and after implementation of the Medical Home.

Conditions

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Quality of Health Care Electronic Health Records

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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1

Physicians that are using paper-based medical charts and who are not receiving Medical Home redesign incentives.

No interventions assigned to this group

2

Physicians that are using Electronic Health Records (EHRs) and who are not undergoing Medical Home redesign.

Electronic health record (EHR)

Intervention Type OTHER

Computer-based system that allows physicians to access and manage patient records electronically.

3

Physicians that are using Electronic Health Records (EHRs) and undergoing Medical Home redesign.

Electronic health record (EHR)

Intervention Type OTHER

Computer-based system that allows physicians to access and manage patient records electronically.

Medical Home redesign

Intervention Type OTHER

Implementation of NCQA Level III Medical Home

Interventions

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Electronic health record (EHR)

Computer-based system that allows physicians to access and manage patient records electronically.

Intervention Type OTHER

Medical Home redesign

Implementation of NCQA Level III Medical Home

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Primary care physicians working in the offices practices in the Hudson Valley, and who are members of the Taconic IPA.

Exclusion Criteria

* Physicians who opt out from the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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New York State Department of Health

OTHER_GOV

Sponsor Role collaborator

The Commonwealth Fund

OTHER

Sponsor Role collaborator

Taconic Health Information Network and Community (THINC)

UNKNOWN

Sponsor Role collaborator

Taconic Independent Practice Association (TIPA)

UNKNOWN

Sponsor Role collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lisa M Kern, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Rainu Kaushal, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

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Weill Cornell Medical College

New York, New York, United States

Site Status

Countries

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United States

References

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Kern LM, Edwards A, Kaushal R. The Patient-Centered Medical Home and Associations With Health Care Quality and Utilization: A 5-Year Cohort Study. Ann Intern Med. 2016 Mar 15;164(6):395-405. doi: 10.7326/M14-2633. Epub 2016 Feb 16.

Reference Type DERIVED
PMID: 26882534 (View on PubMed)

Kaushal R, Edwards A, Kern LM; HITEC Investigators. Association between electronic health records and health care utilization. Appl Clin Inform. 2015 Jan 28;6(1):42-55. doi: 10.4338/ACI-2014-10-RA-0089. eCollection 2015.

Reference Type DERIVED
PMID: 25848412 (View on PubMed)

Kern LM, Edwards A, Kaushal R. The patient-centered medical home, electronic health records, and quality of care. Ann Intern Med. 2014 Jun 3;160(11):741-9. doi: 10.7326/M13-1798.

Reference Type DERIVED
PMID: 24887615 (View on PubMed)

Other Identifiers

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0508190240

Identifier Type: -

Identifier Source: org_study_id

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