Browsing by Subject "Primary care physicians"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Cognitive testing in older primary care patients: A cluster-randomized trial
    (Elsevier, 2015-09) Fowler, Nicole R.; Morrow, Lisa; Chiappetta, Laurel; Snitz, Beth; Huber, Kimberly; Rodriguez, Eric; Saxton, Judith; Department of Medicine, IU School of Medicine
    INTRODUCTION: This study investigated whether neuropsychological testing in primary care (PC) offices altered physician-initiated interventions related to cognitive impairment (CI) or slowed the rate of CI progression. METHODS: This 24-month, cluster-randomized study included 11 community-based PC practices randomized to either treatment as usual (5 practices) or cognitive report (CR; 6 practices) arms. From 2005 to 2008, 533 patients aged ≥65 years and without a diagnosis of CI were recruited; 423 were retested 24 months after baseline. RESULTS: CR physicians were significantly more likely to order cognitive-related interventions (P = .02), document discussions about cognition (P = .003), and order blood tests to rule out reversible CI (P = .002). At follow-up, significantly more CR patients had a medication for cognition listed in their chart (P = .02). There was no difference in the rate of cognitive decline between the groups. DISCUSSION: Providing cognitive information to physicians resulted in higher rates of physician-initiated interventions for patients with CI.
  • Thumbnail Image
    Item
    Primary care physicians’ electronic health record proficiency and efficiency behaviors and time interacting with electronic health records: a quantile regression analysis
    (Oxford University Press, 2022) Nguyen, Oliver T.; Turner, Kea; Apathy, Nate C.; Magoc, Tanja; Hanna, Karim; Merlo, Lisa J.; Harle, Christopher A.; Thompson, Lindsay A.; Berner, Eta S.; Feldman, Sue S.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: This study aimed to understand the association between primary care physician (PCP) proficiency with the electronic health record (EHR) system and time spent interacting with the EHR. Materials and methods: We examined the use of EHR proficiency tools among PCPs at one large academic health system using EHR-derived measures of clinician EHR proficiency and efficiency. Our main predictors were the use of EHR proficiency tools and our outcomes focused on 4 measures assessing time spent in the EHR: (1) total time spent interacting with the EHR, (2) time spent outside scheduled clinical hours, (3) time spent documenting, and (4) time spent on inbox management. We conducted multivariable quantile regression models with fixed effects for physician-level factors and time in order to identify factors that were independently associated with time spent in the EHR. Results: Across 441 primary care physicians, we found mixed associations between certain EHR proficiency behaviors and time spent in the EHR. Across EHR activities studied, QuickActions, SmartPhrases, and documentation length were positively associated with increased time spent in the EHR. Models also showed a greater amount of help from team members in note writing was associated with less time spent in the EHR and documenting. Discussion: Examining the prevalence of EHR proficiency behaviors may suggest targeted areas for initial and ongoing EHR training. Although documentation behaviors are key areas for training, team-based models for documentation and inbox management require further study. Conclusions: A nuanced association exists between physician EHR proficiency and time spent in the EHR.