"Bringing High Performing Systems to Small Practices"

DESCRIPTION (provided by applicant): As implemented, outside of a handful of reference institutions, electronic health record (EHR) systems have not been conclusively shown to improve health outcomes. The New York City Primary Care Information Project (PCIP) is the nation's largest community EHR extension project, with 148 primary care practices and over 1,000 providers in some of the city's poorest neighborhoods. The PCIP's goal is to maximize improvements in the quality of care through this investment of public funds. This public health perspective has led to development and implementation of clinical decision support and integrated registry tools, quality benchmarking, onsite technical assistance in quality improvement and practice redesign, and a novel reward and recognition program. In essence, the PCIP aims to provide even small independent practices with the health system advantages enjoyed by integrated health care organizations. The PCIP is evaluating trends in priority quality measures (e.g., blood pressure and lipid control) among 90 small practices randomized to receive clinical decision support tools and/or financial rewards. This proposed study of 60 comparison practices that have not adopted EHRs will provide a unique opportunity to demonstrate the potential of appropriately implemented health information technology for improving quality of care and reducing health disparities in a large community EHR program.