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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
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.
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.
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
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?
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
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?
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?
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?
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?
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?
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

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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