Dataset Information

The Use of Individual Provider Performance Reports by US Hospitals.

ABSTRACT: Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. We linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals. Multivariable logistic regression was used to model the odds of use as a function of hospital characteristics. In 2015, 65.8% of the 2334 respondents used performance profiles, whereas 59.3% of the 2077 respondents used them in 2013. Report use was associated with non-profit status (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.94-3.95) compared to for-profit, large hospital size (OR, 2.37; 95% CI, 1.56-3.60) compared to small size, highest quartile of bed-adjusted expenditures compared to bottom quartile (OR, 2.09; 95% CI, 1.55-2.82; P < .01), and participation in a health maintenance organization (OR, 1.50; 95% CI, 1.17-1.90; P < .01) or bundled payment program (OR, 1.61; 95% CI, 1.18- 2.19; P < .01). While a majority of hospitals now use such profiles, more than a third do not. The hospitals that do not use performance profiles may be less well positioned to adapt to value-based payment reforms.

SUBMITTER: Rolnick JA

PROVIDER: S-EPMC6407620 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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The Use of Individual Provider Performance Reports by US Hospitals.

Rolnick Joshua A JA Ryskina Kira L KL

Journal of hospital medicine 20180207 8

Medicare reimbursement for hospitals is increasingly tied to performance. The use of individual provider performance reports offers the potential to improve clinical outcomes through social comparison, and isolated cases of clinical dashboard uses at specific institutions have been previously reported. However, little is known about overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. We used data from 2013 to 2015 from the Ameri ...[more]

PMID: 29419821

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Project description:BACKGROUND:Telehealth technology can create a disruptive communication environment for frontline care providers who mediate virtual communication with specialists in electronic consultations. As providers are dealing with various technology features when communicating with specialists, their flexible attitude and behaviors to use various telehealth-related technology features can change the outcome of virtual care service. OBJECTIVE:The objective of this study is to examine frontline care providers' technology adaptation behaviors in the electronic consultation context. From the perspective of frontline care providers, we reapply and retest a theoretical model, reflecting a mechanism through which technology users' personal characteristics and technology adaptation behavior enhance virtual service performance, which is an important performance enabler in this online meeting context. In provider-to-provider communication, particularly, we explore the association among providers' information technology (IT)-related personal characteristics, adaptive telehealth technology use, and virtual service performance. METHODS:An online survey was administered to collect individual providers' personal traits, IT adaptation, and perception on virtual service performance. Partial least squares-structural equation modeling was used to estimate our predictive model of personal traits-IT adaptation, such as exploitative use (use the telehealth technology in a standard way), and exploratory use (use the telehealth technology as innovative way)-and virtual service performance. RESULTS:We collected 147 responses from graduate nursing students who were training to be nurse practitioners in their master's program, resulting in 121 valid responses from the cross-section online survey. Our theoretical model explained 60.0% of the variance in exploitative use of telehealth technology, 44% of the variance in exploratory use of telehealth technology, and 66% of the variance in virtual service performance. We found that exploitative IT use is an important driver to increase virtual service performance (?=0.762, P<.001), and personal characteristics such as habit are positively associated with both exploitative (?=0.293, P=.008) and exploratory use behaviors (?=0.414, P=.006), while computer self-efficacy is positively associated with exploitative use of telehealth technology (?=0.311, P=.047). CONCLUSIONS:This study discusses the unique role of frontline care providers in a virtual care service context and highlights the importance of their telehealth adaptation behavior in provider-to-provider communication. We showed that providers perceive that telehealth technologies should function as intended, otherwise it may create frustration or avoidance of the telehealth technology. Moreover, providers' habitual use of various technologies in daily lives also motivates them to adaptively use telehealth technology for improving virtual care service. Understanding providers' technology habit and adaptation can inform health care policy and further provide a better view of the design of telehealth technology for online communication.

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Dataset Information

The Use of Individual Provider Performance Reports by US Hospitals.

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The Use of Individual Provider Performance Reports by US Hospitals.

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