Do electronic health records used by primary care practices support recommended alcohol-related care?

Katharine Bradley*, James Mccormack, Megan Addis, Leah K. Hamilton, Gwen T. Lapham, Daniel Jonas, Dawn Bishop, Darla Parsons, Cheryl Budimir, Victoria Sanchez, Jennifer Bannon, Gabriela Villalobos, Alex H. Krist, Theresa Walunas, Anya Day

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The quality of alcohol-related prevention and treatment in US primary care is poor. The purpose of this study was to describe the extent to which Electronic Health Records (EHRs) used by 167 primary care practices across 7 states currently include the necessary prompts, clinical support, and performance reporting essential for improving alcohol-related prevention and treatment in primary care. Materials and Methods: Experts from five regional quality improvement programs identified basic EHR features needed to support evidence-based alcohol-related prevention (ie, screening and brief intervention) and treatment of alcohol use disorders (AUD). Data were collected regarding whether EHRs included these features. Results: EHRs from 21 vendors were used by the primary care practices. For prevention, 62% of the 167 practices' EHRs included a validated screening questionnaire, 46% automatically scored the screening instrument, 62% could report the percent screened, and 37% could report the percent screening positive. Only 7% could report the percent offered brief intervention. For alcohol treatment, 49% of practices could report the percent diagnosed with AUD, 58% and 91% allowed documentation of referral and treatment with AUD medication, respectively. Only 3% could report the percent of patients diagnosed with AUD who received treatment. Discussion: Most EHRs observed across 167 primary care practices across 7 US states lacked basic functionality necessary to support evidence-based alcohol-related prevention and AUD treatment. Only 3% and 7% of EHRs, respectively, included the ability to report widely recommended quality measures needed to improve the quality of recommended alcohol-related prevention and treatment in primary care. Conclusion: Improving EHR functionality is likely necessary before alcohol-related primary care can be improved.

Original languageEnglish (US)
Article numberooae125
JournalJAMIA Open
Volume7
Issue number4
DOIs
StatePublished - Dec 1 2024

Funding

This project was supported by Agency for Healthcare Research and Quality [R18HS027076 to K.B., M.A., G.T.L., L.K.H., D.B., D.P., C.B., and A.D.], Agency for Healthcare Research and Quality [R18 HS027078 to D.J.], Agency for Healthcare Research and Quality [R18 HS027080 to J.M. and V.S.], Agency for Healthcare Research and Quality [R18 HS027077 to G.V. and A.H.K.], and Agency for Healthcare Research and Quality [R18HS027088 to J.B. and T.W.].

Keywords

  • alcohol drinking
  • alcohol use disorders
  • electronic health records
  • performance measurement
  • quality improvement

ASJC Scopus subject areas

  • Health Informatics

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