TY - JOUR
KW - Community Mental Health Services
KW - Electronic Health Records
KW - Focus Groups
KW - Humans
KW - Patient Care Planning
KW - Patient-Centered Care
KW - Qualitative Research
KW - Health Information Technology
KW - Mental Health Services
KW - Person-centered care
AU - V. Stanhope
AU - E. B. Matthews
A1 - 
AB - BACKGROUND: Electronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics. METHODS: The study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record. RESULTS: All clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds. CONCLUSIONS: The study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care. TRIAL REGISTRATION: Clinicaltrials.gov , NCT02299492 , registered on November 24, 2014.
AD - Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA. victoria.stanhope@nyu.edu.; Graduate School of Service, Fordham University, 113 West 60th Street, New York, NY, 10023, USA.
BT - BMC medical informatics and decision making
C5 - HIT & Telehealth
CP - 1
CY - England
DO - 10.1186/s12911-019-0897-6
IS - 1
JF - BMC medical informatics and decision making
M1 - Journal Article
N2 - BACKGROUND: Electronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics. METHODS: The study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record. RESULTS: All clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds. CONCLUSIONS: The study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care. TRIAL REGISTRATION: Clinicaltrials.gov , NCT02299492 , registered on November 24, 2014.
PP - England
PY - 2019
SN - 1472-6947; 1472-6947
SP - 019
EP - 6
EP - 168+
T1 - Delivering person-centered care with an electronic health record
T2 - BMC medical informatics and decision making
TI - Delivering person-centered care with an electronic health record
U1 - HIT & Telehealth
U2 - 31438960
U3 - 10.1186/s12911-019-0897-6
VL - 19
VO - 1472-6947; 1472-6947
Y1 - 2019
Y2 - Aug 22
ER -