Delivering person-centered care with an electronic health record

Victoria Stanhope, Elizabeth B. Matthews

    Research output: Contribution to journalArticle

    Abstract

    Background: Electronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics. Methods: The study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record. Results: All clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds. Conclusions: The study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care. Trial registration: Clinicaltrials.gov, NCT02299492, registered on November 24, 2014.

    Original languageEnglish (US)
    Article number168
    JournalBMC Medical Informatics and Decision Making
    Volume19
    Issue number1
    DOIs
    StatePublished - Aug 22 2019

    Fingerprint

    Electronic Health Records
    Quality of Health Care
    Mental Health
    Aptitude
    Information Services
    Consultants
    Focus Groups
    Interviews
    Health
    Research

    Keywords

    • Electronic health records
    • Health information technology
    • Mental health services
    • Person-centered care

    ASJC Scopus subject areas

    • Health Policy
    • Health Informatics

    Cite this

    Delivering person-centered care with an electronic health record. / Stanhope, Victoria; Matthews, Elizabeth B.

    In: BMC Medical Informatics and Decision Making, Vol. 19, No. 1, 168, 22.08.2019.

    Research output: Contribution to journalArticle

    Stanhope, Victoria ; Matthews, Elizabeth B. / Delivering person-centered care with an electronic health record. In: BMC Medical Informatics and Decision Making. 2019 ; Vol. 19, No. 1.
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