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State Funding for Health Information Technology and Selected Ambulatory Healthcare Quality Measures

Journal: Applied Clinical Informatics
ISSN: 1869-0327
DOI: http://dx.doi.org/10.4338/ACI-2013-12-RA-0108
Issue: Vol. 5: Issue 2 2014
Pages: 594-602

State Funding for Health Information Technology and Selected Ambulatory Healthcare Quality Measures

Research Article

L. M. Kern (1, 2, 3, 4), M. Silver (2, 4), R. Kaushal (1, 2, 3, 4, 5, 6), with the HITEC Investigators

(1) Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY.; (2) Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.; (3) Department of Medicine, Weill Cornell Medical College, New York, NY.; (4) Health Information Technology Evaluation Collaborative, New York, NY.; (5) Department of Pediatrics, Weill Cornell Medical College, New York, NY.; (6) New York-Presbyterian Hospital, New York, NY.

Keywords

Quality of Health Care, Electronic health records, primary health care

Summary

Background: Previous studies on the effects of health information technology (health IT) on ambulatory quality have had mixed results. New York State has invested heavily in health IT throughout the State, creating a unique opportunity to assess effects on health care quality across multiple communities. Objective: To determine any association between primary care providers’ receipt of funding from New York State’s Healthcare Efficiency and Affordability Law for New Yorkers Program (HEAL NY) and ambulatory quality of care Methods: A statewide, longitudinal cohort study of primary care physicians in New York State was conducted. Data regarding which primary care physicians received funding through the HEAL NY program (Phase 5 or Phase 10) in 2008 or 2009 were obtained from the New York State Department of Health. Health care quality in 2010 was measured using claims data that had been aggregated across 7 commercial health plans across the state. Physicians were divided into 2 groups, based on receipt of HEAL funding (yes/no). Any association was measured between study group and each of 7 quality measures, all of which appear in the Stage 1 federal Meaningful Use program. Negative binomial regression was used, adjusting for provider gender and specialty. Results: The study included 3,988 primary care providers, of whom 863 (22%) had received HEAL NY funding. The HEAL-funded physicians provided higher quality of care on 5 of the 7 measures: breast cancer screening, eye exams in patients with diabetes, nephropathy screening in patients with diabetes, influenza vaccination and pneumococcal vaccination (p<0.0001 for all adjusted comparisons). The HEAL-funded group provided higher quality of care by an absolute 2 to 6 percentage points per measure for those 5 measures. Conclusion: Primary care physicians who received state funding for health IT provided higher quality of care than those who did not receive such funding.

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