TY - JOUR
KW - Collaboration
KW - Communication
KW - EHR
KW - patient-centered medical home
AU - D. A. Chase
AU - D. A. Dorr
AU - D. J. Cohen
AU - J. S. Ash
A1 - 
AB - BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood. They also identified the communication channels used in these collaborations. We used k-means clustering to identify communication patterns. RESULTS: Within the clinic, half of the primary care providers (PCPs) identified a care manager as their most recent collaborator. Outside specialists were their most common external collaborators. Ninety-two percent of the non-PCP participants identified PCP's as their most recent internal collaborators. The best model for communication channel usage (p < .0001) had six clusters. In general, inside communications were more informal but outside collaborations were more often formal written communications (faxes, letters) or the exchange of electronic health record progress notes. But there were exceptions to these patterns and in many cases multiple channels were used for the same collaboration. CONCLUSION: Systems design (and redesign) needs to focus on reducing communications load and increasing communication effectiveness while maintaining flexibility.
BT - Studies in health technology and informatics
C5 - Education & Workforce; Measures
CY - Netherlands
JF - Studies in health technology and informatics
N2 - BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood. They also identified the communication channels used in these collaborations. We used k-means clustering to identify communication patterns. RESULTS: Within the clinic, half of the primary care providers (PCPs) identified a care manager as their most recent collaborator. Outside specialists were their most common external collaborators. Ninety-two percent of the non-PCP participants identified PCP's as their most recent internal collaborators. The best model for communication channel usage (p < .0001) had six clusters. In general, inside communications were more informal but outside collaborations were more often formal written communications (faxes, letters) or the exchange of electronic health record progress notes. But there were exceptions to these patterns and in many cases multiple channels were used for the same collaboration. CONCLUSION: Systems design (and redesign) needs to focus on reducing communications load and increasing communication effectiveness while maintaining flexibility.
PP - Netherlands
PY - 2017
SN - 0926-9630; 0926-9630
SP - 59
EP - 64
EP - 
T1 - Collaborators and Communication Channels in Eight Patient-Centered Medical Homes
T2 - Studies in health technology and informatics
TI - Collaborators and Communication Channels in Eight Patient-Centered Medical Homes
U1 - Education & Workforce; Measures
U2 - 28186016
VL - 234
VO - 0926-9630; 0926-9630
Y1 - 2017
ER -