TY - JOUR
KW - Adolescent
KW - Attitude of Health Personnel
KW - Child
KW - Child Behavior Disorders/epidemiology
KW - Child, Preschool
KW - Diffusion of Innovation
KW - Efficiency, Organizational
KW - Electronic Health Records
KW - Humans
KW - Mass Screening/organization & administration/utilization
KW - Outcome and Process Assessment (Health Care)
KW - Pediatrics
KW - Physician's Practice Patterns
KW - Primary Health Care/organization & administration
KW - Time Factors
KW - United States
AU - K. Hacker
AU - R. Penfold
AU - F. Zhang
AU - S. B. Soumerai
A1 - 
AB - OBJECTIVE: The objective was to determine whether transitioning from paper to electronic health records affected behavioral health screening rates in a large Northeastern pediatric practice. METHODS: The study setting was a pediatric practice with seven pediatricians, serving about 6,000 patients. The patient population was diverse (54% nonwhite, 40% publicly insured or self-paying, and 31% non-English speakers). An interrupted times series design was used to evaluate the impact of electronic record implementation on behavioral health screening rates. The main outcome measure was the rate of such screening 18 months before and 36 months after implementation. RESULTS: The rate of behavioral health screening increased from 70% to 91% during the baseline period. The training period-six months before electronic record implementation-was associated with a 28% decline in adjusted screening rates (from 83.3% to 55.5%). Only 50% of eligible youths were screened in the first month after implementation. The screening rate took more than three years to recover to baseline levels, climbing to 82% by April 2008. CONCLUSIONS: Practice changes resulting from electronic record adoption were highly disruptive of care, and disruptions took several years to resolve completely. When medical assistants rather than physicians were tasked with transferring data from paper screening forms to the electronic record, reporting compliance improved. Compliance with Healthcare Effectiveness Data and Information Set standards and Medicaid performance measures will likely be similarly affected as electronic records are implemented nationwide. Although implementing a fully automated medical record has some benefits, the unintended effects on care after implementation must be acknowledged.
BT - Psychiatric services (Washington, D.C.)
C5 - HIT & Telehealth
CP - 3
CY - United States
DO - 10.1176/appi.ps.201100207
IS - 3
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: The objective was to determine whether transitioning from paper to electronic health records affected behavioral health screening rates in a large Northeastern pediatric practice. METHODS: The study setting was a pediatric practice with seven pediatricians, serving about 6,000 patients. The patient population was diverse (54% nonwhite, 40% publicly insured or self-paying, and 31% non-English speakers). An interrupted times series design was used to evaluate the impact of electronic record implementation on behavioral health screening rates. The main outcome measure was the rate of such screening 18 months before and 36 months after implementation. RESULTS: The rate of behavioral health screening increased from 70% to 91% during the baseline period. The training period-six months before electronic record implementation-was associated with a 28% decline in adjusted screening rates (from 83.3% to 55.5%). Only 50% of eligible youths were screened in the first month after implementation. The screening rate took more than three years to recover to baseline levels, climbing to 82% by April 2008. CONCLUSIONS: Practice changes resulting from electronic record adoption were highly disruptive of care, and disruptions took several years to resolve completely. When medical assistants rather than physicians were tasked with transferring data from paper screening forms to the electronic record, reporting compliance improved. Compliance with Healthcare Effectiveness Data and Information Set standards and Medicaid performance measures will likely be similarly affected as electronic records are implemented nationwide. Although implementing a fully automated medical record has some benefits, the unintended effects on care after implementation must be acknowledged.
PP - United States
PY - 2012
SN - 1557-9700; 1075-2730
SP - 256
EP - 261
EP - 
T1 - Impact of electronic health record transition on behavioral health screening in a large pediatric practice
T2 - Psychiatric services (Washington, D.C.)
TI - Impact of electronic health record transition on behavioral health screening in a large pediatric practice
U1 - HIT & Telehealth
U2 - 22267253
U3 - 10.1176/appi.ps.201100207
VL - 63
VO - 1557-9700; 1075-2730
Y1 - 2012
ER -