Association of Electronic Health Records Access and Coordination Between Primary Care Providers and Public Health Nurse Home Visitors in the United States
研究美国护士家访团队对电子健康档案的访问情况，发现访问权限与家访者和初级保健提供者之间的协作显著相关，对改善跨机构协调有参考价值。
OBJECTIVE: To measure nurse home visiting teams' access to electronic health records (EHR) and determine if access to EHR is associated with increased nurse home visitor collaboration with primary care providers in the United States. STUDY SETTING AND DESIGN: Nurse-Family Partnership (NFP) is an evidence-based home visiting program for first-time parents experiencing adversities. We conducted an observational study using data from 265 local NFP agencies in the United States. We used multivariate regression models to estimate the association between home visitors' EHR access and relational coordination with primary care providers. DATA SOURCES AND ANALYTIC SAMPLE: We linked data from the 2021 NFP Collaboration with Community Providers Survey to 2021 NFP program implementation data and 2010 Rural-Urban Commuting Area Codes. We matched 265 survey respondents to their NFP teams' implementation data, including those with client visits between September 1, 2021, and December 31, 2021. PRINCIPAL FINDINGS: =19.44, p < 0.01). Most NFP teams with EHR access reported read access (91%), ability to document (64%), and receiving program referrals (53%). EHR access was significantly associated with increased relational coordination with women's care providers (0.36-point difference, 95% CI 0.17 to 0.55, p < 0.01) and pediatric care providers (0.39-point difference, 95% CI 0.18 to 0.61, p < 0.01). CONCLUSIONS: Access to EHRs varies by NFP team and agency type and is associated with greater relational coordination with primary care providers. Increasing home visitors' access to EHRs may help to facilitate collaboration with primary care providers.