Table 2 Build health information technology to support data-informed QI. ERIC strategies included in EvidenceNOW interventions with Proctor specifications
Expected outcomes: Ability to generate ABCS reports sufficient HIT capacity, ability to generate ABCS reports, ABCS documentation, data interoperability and sharing. Sustained performance quality measurement and use of data for QI Justification: Practices need population-level data and interoperability to improve quality and optimize care delivery, but they have little or no HIT capacity for this. Practices may need additional, external data infrastructure to provide robust practice-level, clinician-level, and patient-level data on demand. Practices often need internal support to access, validate, and use data for QI. Practices are motivated to improve upon seeing their own data | |||||
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No. co-ops | Name it | Specify it | |||
ERIC cluster | ERIC strategy* | Actor | Specific action(s) | Target | |
5 | Adapt and tailor to context | Use data experts | Cooperative leadership, data experts | Hire health informatics technology experts (called “data experts” in this table) to connect practices to external data infrastructures or hire practice facilitators skilled in health informatics technology (called HIT-PFs) to assist practices in generating and understanding EHR data | Cooperative, practice |
5 | Adapt and tailor to context | Use data warehousing techniques | Data expert, HIT-PF | Connect practice EHR to warehouse, repository, and/or other external durable infrastructures (i.e., registries and software platforms) | Practice |
6 | Use evaluative and iterative strategies | Develop and implement tools for quality monitoring | Data expert, HIT-PF | Perform the data extraction, data normalization, and “back-end” data validation necessary for data warehousing and other data platforms | Practice, data infrastructure |
6 | Use evaluative and iterative strategies | Develop and organize quality monitoring systems | Data expert, HIT-PF, PF | Connect practices to additional data interfaces for receiving ABCS data and other types of metrics (i.e., access to data software platforms like popHealth or Sharepoint or cooperative dashboards) | Practice |
3 | Utilize financial strategies | Fund and contract (and/or negotiate) with vendors for the clinical innovation | Cooperative leadership | Reimburse for registry connections for the duration of EvidenceNOW; negotiate with EHR vendors to connect practices to data infrastructure | Practice |
2 | Change infrastructure | Change records systems | Data expert | Help practices upgrade to new EHR and/or modify existing EHRs for efficiency and accuracy | Practice |
6 | Provide interactive assistance | Provide local technical assistance | Data expert, HIT-PF, PF | Audit charts to validate data reports; assist with helping practices improve ABCS documentation; help practices run/generate/pull reports; troubleshoot dashboards; help practice staff transition to and learn to use new EHR, if needed | Practice, PF |
7 | Use evaluative and iterative strategies | Audit and provide feedback | Data expert, HIT-PF, PF | Share ABCS data for feedback and monitor improvement over time. Most used ABCS data for audit and provide feedback, and several provided benchmarking to similar practices; a few included survey items and other sources of data for feedback | Practice |