The association between EHRs and care coordination varies by team cohesion

Ilana Yonas, Mary Reed, Stephen M. Shortell, Thomas G. Rundall, Jim Bellows, John Hsu

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective To examine whether primary care team cohesion changes the association between using an integrated outpatient-inpatient electronic health record (EHR) and clinician-rated care coordination across delivery sites. Study Design. Self-administered surveys of primary care clinicians in a large integrated delivery system, collected in 2005 (N = 565), 2006 (N = 678), and 2008 (N = 626) during the staggered implementation of an integrated EHR (2005-2010), including validated questions on team cohesion. Using multivariable regression, we examined the combined effect of EHR use and team cohesion on three dimensions of care coordination across delivery sites: access to timely and complete information, treatment agreement, and responsibility agreement. Principal Findings. Among clinicians working in teams with higher cohesion, EHR use was associated with significant improvements in reported access to timely and complete information (53.5 percent with EHR vs. 37.6 percent without integrated-EHR), agreement on treatment goals (64.3 percent vs. 50.6 percent), and agreement on responsibilities (63.9 percent vs. 55.2 percent, all p < .05).We found no statistically significant association between use of the integrated-EHR and reported care coordination in less cohesive teams. Conclusion. The association between EHR use and reported care coordination varied by level of team cohesion. EHRs may not improve care coordination in less cohesive teams.

Original languageEnglish (US)
Pages (from-to)438-452
Number of pages15
JournalHealth Services Research
Volume49
Issue number1 PART 2
DOIs
StatePublished - Jan 1 2014

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Electronic Health Records
Primary Health Care
Integrated Delivery of Health Care
Inpatients
Outpatients
Therapeutics

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Yonas, I., Reed, M., Shortell, S. M., Rundall, T. G., Bellows, J., & Hsu, J. (2014). The association between EHRs and care coordination varies by team cohesion. Health Services Research, 49(1 PART 2), 438-452. https://doi.org/10.1111/1475-6773.12136

The association between EHRs and care coordination varies by team cohesion. / Yonas, Ilana; Reed, Mary; Shortell, Stephen M.; Rundall, Thomas G.; Bellows, Jim; Hsu, John.

In: Health Services Research, Vol. 49, No. 1 PART 2, 01.01.2014, p. 438-452.

Research output: Contribution to journalArticle

Yonas, I, Reed, M, Shortell, SM, Rundall, TG, Bellows, J & Hsu, J 2014, 'The association between EHRs and care coordination varies by team cohesion', Health Services Research, vol. 49, no. 1 PART 2, pp. 438-452. https://doi.org/10.1111/1475-6773.12136
Yonas, Ilana ; Reed, Mary ; Shortell, Stephen M. ; Rundall, Thomas G. ; Bellows, Jim ; Hsu, John. / The association between EHRs and care coordination varies by team cohesion. In: Health Services Research. 2014 ; Vol. 49, No. 1 PART 2. pp. 438-452.
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