Browsing by Author "Yano, Elizabeth M."

Now showing 1 - 4 of 4
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    Advancing the Science of Electronic Health Record Transitions
    (Springer, 2023) Weiner, Michael; Rinne, Seppo T.; Haggstrom, David A.; Yano, Elizabeth M.; Medicine, School of Medicine
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    Challenges with Delivering Gender-Specific and Comprehensive Primary Care to Women Veterans
    (Elsevier, 2015-01) Bergman, Alicia A.; Frankel, Richard M.; Hamilton, Alison B.; Yano, Elizabeth M.; Department of Medicine, IU School of Medicine
    Background The growing presence of women veterans in Veterans Administration (VA) settings has prompted the need for greater attention to clinical proficiency related to women's health (WH) primary care needs. Instead of making appointments for multiple visits or referring patients to a WH clinic or alternate site for gender-specific care, a comprehensive primary care model now allows for women veteran patients be seen by primary care providers (PCPs) who have WH training/experience and can see patients for both primary and WH care in the context of a single visit. However, little is currently known about the barriers and facilitators WH-PCPs face in using this approach to incorporate gender-specific services into women veterans' primary care services. Methods We conducted qualitative in-depth interviews with 22 WH-PCPs at one Midwestern VA Medical Center. All participants were members of one of four outpatient primary care clinics within the main medical center, one off-site satellite clinic, or two off-site community-based outpatient clinics. Results Inductive thematic analysis identified six themes: 1) Time constraints, 2) importance of staff support, 3) necessity of sufficient space and equipment/supplies, 4) perceptions of discomfort among patients with trauma histories, 5) lack of education/training, and 6) challenges with scheduling/logistics. Conclusion Although adequate staff was a key facilitator, the findings suggest that there may be barriers that undermine the ability of VA WH-PCPs to provide high-quality, comprehensive primary and gender-specific care. The nature of these barriers is multifactorial and multilevel in nature, and may therefore require special policy and practice action.
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    Patient Aligned Care Teams (PACT): VA’s Journey to Implement Patient-Centered Medical Homes
    (Springer, Part of Springer Science+Business Media, 2014-07) Yano, Elizabeth M.; Bair, Matthew J.; Carrasquillo, Olveen; Krein, Sarah L.; Rubenstein, Lisa V.; Department of Medicine, IU School of Medicine
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    Using Research to Transform Electronic Health Record Modernization: Advancing a VA Partnered Research Agenda to Increase Research Impacts
    (Springer, 2023) Cogan, Alison M.; Rinne, Seppo T.; Weiner, Michael; Simon, Steven; Davila, Jessica; Yano, Elizabeth M.; Medicine, School of Medicine
    Background: The U.S. Department of Veterans Affairs (VA) is undergoing an enterprise-wide transition from a homegrown electronic health record (EHR) system to a commercial off-the-shelf product. Because of the far-reaching effects of the EHR transformation through all aspects of the healthcare system, VA Health Services Research and Development identified a need to develop a research agenda that aligned with health system priorities so that work may inform evidence-based improvements in implementation processes and outcomes. Objective: The purpose of this paper is to report on the development of a research agenda designed to optimize the EHR transition processes and implementation outcomes in a large, national integrated delivery system. Design: We used a sequential mixed-methods approach (portfolio assessment, literature review) combined with multi-level stakeholder engagement approach that included research, informatics, and healthcare operations experts in EHR transitions in and outside the VA. Data from each stage were integrated iteratively to identify and prioritize key research areas within and across all stakeholder groups. Participants: VA informatics researchers, regional VA health system leaders, national VA program office leaders, and external informatics experts with EHR transition experience. Key results: Through three rounds of stakeholder engagement, priority research topics were identified that focused on operations, user experience, patient safety, clinical outcomes, value realization, and informatics innovations. Conclusions: The resulting EHR-focused research agenda was designed to guide development and conduct of rigorous research evidence aimed at providing actionable results to address the needs of operations partners, clinicians, clinical staff, patients, and other stakeholders. Continued investment in research and evaluation from both research and operations divisions of VA will be critical to executing the research agenda, ensuring its salience and value to the health system and its end users, and ultimately realizing the promise of this EHR transition.