Next-generation health IT requires primary care input

Practicing clinicians and patients have the clearest understanding of what they need from health IT and should be shaping the national HIT research agenda, according to an article published in the latest edition of the Journal of the American Board of Family Medicine.

Researchers and clinicians need to team up to fully describe the workflow, information needs and communication processes required for health IT to effectively support clinicians' needs, the authors write. This partnership should extend to the practice-level tasks of using data to optimize the care of whole panels of patients in order to redesign care to support population needs.

The HIT Working Group for the North American Primary Care Research Group has been involved in such work through practice-based research networks (PBRNs) to identify specific ways in which health IT could better meet users' documentation, information sharing, decision-making and care delivery needs.

These networks exist in every state, according to the article, and need to involve clinicians, patients, communities, informaticists, systems engineers and researchers to develop, test and inform the next generation of health IT.

While more than half of patient encounters occur in primary care, most health IT research funding has been directed to hospitals, the authors note. However, the type of health IT research that primary care needs does not fit neatly into traditional funding sources. So far, the Agency for Healthcare Research and Quality (AHRQ) has been the main source of support for primary care health IT research, which the authors call critically important, but insufficient. AHRQ recently reported that electronic health records used in pediatrics need certain specific functionalities not used in EHRs designed for adult care, and urged new functionality be added "thoughtfully."

Previous AHRQ guidance outlined ways even small physician practices can use HIT for quality improvement.

This latest article calls for policy to support health IT research in primary care, and points out the problem of promoting EHR adoption by clinicians, systems that then have to be jettisoned when aligning with a hospital. It calls on vendors to create open source applications that can be integrated with hospital systems when market consolidation occurs, and for clinicians and researchers to pursue advanced training in informatics as a potential way to retain greater control over health IT.

To learn more:
- read the article