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Facilitators help solve EHR data issues

Primary care practices that used facilitators to solve quality improvement challenges tied to electronic health records overcame many of those problems, according to a report appearing in the Journal of the American Board of Family Medicine.

“The goal of facilitation is to help practices transform into independent learning systems capable of continuous and self-directed improvement,” Jennifer R. Hemler, PhD, of the department of family medicine and community health at Rutgers University in New Jersey and colleagues wrote. “Little is known about how facilitators respond to practice-level EHR data challenges that create barriers to performing data-driven [quality improvement].”

Researchers placed 136 facilitators in 1,500 small-to-medium-sized primary care practices to comprehend the challenges facilitators face in using EHR performance data for quality improvement. Hemler and colleagues also looked at how these same facilitators assisted in solving the challenges faced by data driven quality improvement.

Researchers found that the challenges were lack of data, where the practice could not produce measure reports or access other data related to aspirin use in high-risk individuals, BP control, cholesterol management, and smoking cessation counseling; partial or incomplete data, where the practice could not produce measure reports on this type of data but some data was available; and inaccurate clinical performance data, where reports with this type of data could be produced, but had errors.

“We found that facilitators responded to these challenges, respectively, by using other data sources or tools to fill in for missing data, approximating performance reports and generating patient lists, and teaching practices how to document care and confirm performance measures,” Hemler and colleagues wrote.

“In addition, facilitators helped practices communicate with EHR vendors or health systems in requesting data they needed. Overall, facilitators tailored strategies to fit the individual practice and helped build data skills and trust,” they added.

Researchers wrote that EHRs will be increasingly needed for quality improvement measures as health care moves from fee-for-service to value-based, and suggested their findings may be only one role that facilitators may be able to play in primary care.

“With greater stakeholder investment, facilitators can extend their support to larger numbers of practices with EHR data challenges, helping them meet the demands of required performance programs and achieve their practice improvement goals,” Hemler and colleagues wrote.

“Without support, it is uncertain how practices, especially those experiencing challenges using their EHR data for [quality improvement], will perform in these programs.” – by Janel Miller