Patient Centered Evaluation of Computerized Patient Records System

NCT00935584 | Completed Results

• 1 other identifier: IIR 07-196
• Study Type: interventional
• Target: 151
• Locations: 1 country
• Sites: 1

Brief Summary

The VHA is a leader in electronic medical records (EMR) use for patient care. It is believed that EMR use by doctors will improve patient-centeredness of visits, and improve clinical care. The proposed study will determine how doctors should use the EMR during patient consultations. We will also develop a training program to improve doctors ability to communicate with patients while using EMR.

Conditions

Electronic Medical Records

Keywords

Communication; Doctor-patient relations; medical informatics; patient-centered care; medical records systems, computerized

Outcome Measures

Primary Outcomes (7)

• Change in Patient's Satisfaction, Change in Provider's Satisfaction (Mean/SD)

  Three patient satisfaction subscales were analyzed (range 1-5 for all subscales, 1=not satisfied at all, 5=very satisfied). Subscale 1 measures physician's use of patient center communication; Subscale 2 measures clinical competence and skills; Subscale 3 measures physician interpersonal skills. Four provider satisfaction subscales were analyzed (range 1-5 for all subscales, 1=not satisfied at all, 5=very satisfied). Subscale 1 measures quality of physician-patient relation; Subscale 2 measures patient's non-demanding co-operative nature, Subscale 3 measures satisfaction with data collection; Subscale 4 measures satisfaction with use of visit time. Change in patient's satisfaction and change in provider's satisfaction from pre to post-intervention clinic visit was reported for the above subscales. Higher change score indicates better outcome. Mean and standard deviation were reported.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in Patient's Satisfaction, Change in Provider's Satisfaction (Median/Range)

  Three patient satisfaction subscales were analyzed (range 1-5 for all subscales, 1=not satisfied at all, 5=very satisfied). Subscale 1 measures physician's use of patient center communication; Subscale 2 measures clinical competence and skills; Subscale 3 measures physician interpersonal skills. Four provider satisfaction subscales were analyzed (range 1-5 for all subscales, 1=not satisfied at all, 5=very satisfied). Subscale 1 measures quality of physician-patient relation; Subscale 2 measures patient's non-demanding co-operative nature, Subscale 3 measures satisfaction with data collection; Subscale 4 measures satisfaction with use of visit time. Change in patient's satisfaction and change in provider's satisfaction from pre to post-intervention clinic visit was reported for the above subscales. Higher change score indicates better outcome. Median and range were reported.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in Patient Engagement

  Change in proportion of time spent on physician-patient communication from pre to post-intervention clinic visit was calculated. Positive change indicates increased time spent on patient communication. Mean and standard deviation of outcomes were reported in this table.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in Total Number of EMR Mouse Click Per Visit (Mean/SD)

  For EMR use, we assessed the change in total number of mouse click per-visit, positive score indicates increased EMR use. Mean and standard deviation of outcome were reported in this table.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in Total Number of EMR Mouse Click Per Visit (Median/Range)

  For EMR use, we assessed the change in total number of mouse click per-visit, positive score indicates increased EMR use.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in EMR Mouse Click Per Minute Per Visit (Mean/SD)

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

• Change in EMR Mouse Click Per Minute Per Visit (Median/Range)

  For EMR use, we assessed the change in the average number of mouse clicks per minute per-visit, positive score indicates increased EMR use.

  Baseline clinic visit and post-intervention clinic visit (over a period of 1 year)

Study Arms (1)

PACE Study

OTHER

The study utilized a quasi-experimental pre-post intervention design. The intervention provided was physician education to improve EMR use and communication. Physician training in patient-centered EMR use was developed. The conceptual model of "patient-centered communication" will provide the underlying framework for the training aimed at improving physicians interviewing and communication skills.

Behavioral: Physician training in patient-centered emr use

Interventions

Physician training in patient-centered emr use BEHAVIORAL

This intervention was performed in between the pre-intervention (Baseline) clinic visit and post intervention clinic visit.

Also known as: Educational Workshop

PACE Study

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult (age\>18) male and female patients from participating study providers' practices who have an established a doctor-patient relationship with their provider and require a minimum of 2 primary care clinic visits/year based on historical clinic data.

You may not qualify if:

• Patients with significant communication disability (severe speech and hearing impairment, severe dementia, or a mental health condition resulting in a non-communicative patient);
• patients are considered mentally incompetent to provide informed written consent;
• a life expectancy of less than 1 year.

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA San Diego Healthcare System, San Diego

San Diego, California, 92161, United States

Location

MeSH Terms

Conditions

Communication

Condition Hierarchy (Ancestors)

Behavior

Limitations and Caveats

Study limitations include inability to capture EHR activity outside the visit, study only primary care providers at a single organization (VA) and only one EHR system, this limits generalizability of the findings to other setting.

Results Point of Contact

• Title: Dr. Zia Agha
• Organization: VA san Diego Healthcare System

zia.agha@va.gov

8586421295

Study Officials

• Zia Agha, MD MS

  VA San Diego Healthcare System, San Diego

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 7, 2009
• First Posted: July 9, 2009
• Study Start: May 1, 2010
• Primary Completion: February 1, 2013
• Study Completion: April 1, 2013
• Last Updated: November 6, 2015
• Results First Posted: November 6, 2015

Record last verified: 2015-10

Locations

US (1)