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Evaluating the Effects of EHRs, P4P and Medical Home Redesign in the Hudson Valley

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00793065
Recruitment Status : Completed
First Posted : November 19, 2008
Last Update Posted : February 23, 2017
Sponsor:
Collaborators:
New York State Department of Health
The Commonwealth Fund
Taconic Health Information Network and Community (THINC)
Taconic Independent Practice Association (TIPA)
Information provided by (Responsible Party):
Weill Medical College of Cornell University

Study Description
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Brief Summary:
The investigators will conduct a longitudinal cohort study with concurrent controls. The investigators will include all primary care physicians in the Hudson Valley including family practitioners, internists, and pediatricians. The purpose of this study is to determine the effects of implementing electronic health records (EHRs), pay-for-performance incentives for physicians (P4P), and Medical Home redesign on health care quality, cost and patient experience in the Hudson Valley.

Condition or disease Intervention/treatment
Quality of Health Care Electronic Health Records Other: Electronic health record (EHR) Other: Medical Home redesign

Detailed Description:
The Hudson Valley is implementing several innovative programs to potentially improve quality and reduce the cost of health care delivered. First the Taconic Health Information Network and Communities Regional Health Information Organization (THINC RHIO) is facilitating diffusion of EHRs in office practices in the Hudson Valley. Second, THINC RHIO is also offering a strategic approach to pay-for-performance. Third, an additional component of the THINC P4P project will be an added financial incentive for private practice physicians who implement and reach Level II of Physician Practice Connections® - Patient Centered Medical Home (PCMH)™, NCQA's new national recognition system for physician practices. Our study will seek to determine the effect of each of these initiatives on health care quality and cost of care in the Hudson Valley. We will also measure the patient experience before and after implementation of the Medical Home.
Study Design
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Study Type : Observational
Actual Enrollment : 438 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Evaluating the Effects of EHRs, P4P and Medical Home Redesign in the Hudson Valley
Actual Study Start Date : January 2008
Actual Primary Completion Date : December 2012
Actual Study Completion Date : December 2012
Groups and Cohorts
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Group/Cohort Intervention/treatment
1
Physicians that are using paper-based medical charts and who are not receiving Medical Home redesign incentives.
2
Physicians that are using Electronic Health Records (EHRs) and who are not undergoing Medical Home redesign.
 Other: Electronic health record (EHR)
Computer-based system that allows physicians to access and manage patient records electronically.
3
Physicians that are using Electronic Health Records (EHRs) and undergoing Medical Home redesign.
 Other: Electronic health record (EHR)
Computer-based system that allows physicians to access and manage patient records electronically.

Other: Medical Home redesign
Implementation of NCQA Level III Medical Home


Outcome Measures
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Primary Outcome Measures :
  1. health care quality (as determined by previously selected and approved quality indicators) [ Time Frame: 5 years ]
  2. health care utilization [ Time Frame: 5 years ]

Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
All primary care physicians (i.e. general internists, pediatricians and family practice physicians) in the Hudson Valley who are members of the Taconic Independent Practice Association (IPA).
Criteria

Inclusion Criteria:

  • Primary care physicians working in the offices practices in the Hudson Valley, and who are members of the Taconic IPA.

Exclusion Criteria:

  • Physicians who opt out from the study.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00793065


Locations
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United States, New York
Weill Cornell Medical College
New York, New York, United States, 10021
Sponsors and Collaborators
Weill Medical College of Cornell University
New York State Department of Health
The Commonwealth Fund
Taconic Health Information Network and Community (THINC)
Taconic Independent Practice Association (TIPA)
Investigators
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Principal Investigator: Lisa M Kern, MD, MPH Weill Medical College of Cornell University
Principal Investigator: Rainu Kaushal, MD, MPH Weill Medical College of Cornell University
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Weill Medical College of Cornell University
ClinicalTrials.gov Identifier: NCT00793065    
Other Study ID Numbers: 0508190240
First Posted: November 19, 2008    Key Record Dates
Last Update Posted: February 23, 2017
Last Verified: February 2017
Keywords provided by Weill Medical College of Cornell University:
electronic health records
health information technology
physician incentives
quality of health care