BEGIN:VCALENDAR CALSCALE:GREGORIAN VERSION:2.0 METHOD:PUBLISH PRODID:-//Drupal iCal API//EN X-WR-TIMEZONE:America/New_York BEGIN:VTIMEZONE TZID:America/New_York BEGIN:DAYLIGHT TZOFFSETFROM:-0500 RRULE:FREQ=YEARLY;BYMONTH=3;BYDAY=2SU DTSTART:20070311T020000 TZNAME:EDT TZOFFSETTO:-0400 END:DAYLIGHT BEGIN:STANDARD TZOFFSETFROM:-0400 RRULE:FREQ=YEARLY;BYMONTH=11;BYDAY=1SU DTSTART:20071104T020000 TZNAME:EST TZOFFSETTO:-0500 END:STANDARD END:VTIMEZONE BEGIN:VEVENT SEQUENCE:1 X-APPLE-TRAVEL-ADVISORY-BEHAVIOR:AUTOMATIC 97166 20230710T153804Z DTSTART;TZID=America/New_York:20230719T100000 DTEND;TZID=America/New_York:2 0230719T120000 URL;TYPE=URI:https://www.wpi.edu/news/calendar/events/phd-d issertation-defense-amy-finn PhD Dissertation Defense: Amy Finn \n\n\n \n \n\n\n\n\n\n\n\n\nImpact of an Organization-Wide Electronic Health Record System on Clinically Integrated Patient Care\nAbstract: \nClinically integrated care delivery is a major goal of health care organ izations, focused on the horizontal process of care across entities and ti me. We constructed a 4-stage model based on the literature to conceptualiz e in broad terms how health care systems in the United States have adopted integration, moving from vertical integration that brings different healt h care entities into the same organization to technical integration using the same organization-wide electronic health record (EHR) system across th e disparate entities in a system. Clinical integration is enabled by techn ical integration, but few studies have examined the organizational dynamic s by which this occurs. \nThis research explored the effects of an organiz ation-wide EHR on clinical integration through an affordance-actualization lens, centered on Primary Care perspectives. We carried out our research at a large health care system that had recently implemented the Epic EHR s ystem organization wide. Using an IRB-approved protocol, we interviewed 10 Primary Care Physicians (PCPs) in 2019–2020, with a second round of int erviews conducted in 2022 with 7 of the same PCPs. Using grounded theory, we explored the effects of the EHR on communication, on care coordination, and on physician engagement. We also identified themes that broadly refle cted PCPs experiences using the EHR, capturing enablers and challenges at environmental and individual levels. \nOur analysis identified that overal l, the PCPs interviewed found the organization-wide EHR offered value and required thinking like a system. The EHR gave them a voice in proactively communicating care plans and rationale. PCPs found that integration suppor ted improved communication and were enthusiastic about the use of Epic Sec ure Chat to directly address patient care issues requiring rapid response. They considered their role as the “Grand Coordinator” of care, suppor ting care teams with greater access to patient information as well an as a bility to manage urgent patient needs. In terms of engagement, PCPs used E HR features to change care and appreciated the connectedness afforded thro ugh use of the EHR. Challenges included different practice cultures, infor mation overload, varying clarity of communications, noise in the system fr om reminders, distribution of duplicate information, additional workload, and frustrations with EHR usability. \nBased on these findings and the lit erature, we used an affordance-actualization lens to investigate harnessin g technical integration to accelerate clinical integration. We identified five affordances including (1) accessing and using patient data through a unified data source, (2) visualizing system requirements and patient needs , (3) facilitating provider to provider communication, (4) engaging primar y care physicians throughout a health care system, and (5) coordinating ca re across providers and site. Each affordance was examined related to its existence, actualization, and expected outcome. Our work contributes to th e literature by introducing the engagement affordance, and presenting depe ndencies and drivers that enable the actualization of clinical integration through care coordination. Another contribution from our analysis is prac tical insights that can inform the implementation of an organization-wide EHR to facilitate movement towards clinical integration. \nDissertation Co mmittee:\nProf. Sharon Johnson (Chair)\n Dr. William Corbett\n Prof. D iane Strong\n Prof. Bengisu Tulu\n\n\nJuly 19, 2023 (Wednesday)\n10:00 A M – 12:00 PM \n Zoom link\nhttps://wpi.zoom.us/j/92239523844\nAmy M. F inn\nAmy is a part-time Ph.D. candidate in Business Administration, with a focus in Operations Management. Her research interests center strategical ly and operationally on process transformation and improvement of business practices across industries, specializing in the health care field.\nAmy has significant experience working in pre- and post-IPO high technology co mpanies and health care organizations. She currently works in the medical device industry, in clinical strategy. Amy has managed multiple large tech nology and health care transforma­tion programs, including transitions of care and ambulatory care manage­ment models. This rich experience contri butes unique insights to her research. Amy holds a dual baccalaureate in B acteriology and English from UCLA, a Pharm.D. from USC, a Ph.D. in Pharmac eutical Chemistry from UC San Francisco Medical Center, two Post Doctoral Fellowships in Clinical and Experimental Pharmacology, an MBA from WPI (Cl ass of 2009), and a Master’s in Public Health (MPH) from UMass Medical S chool/UMass Amherst. She has extensive knowledge of program management, pr ocess and performance improvement, and Agile Scrum. Amy has been an author on multiple technical publications, book chapters, and white papers.\nCon tact: amfinn@wpi.edu\n\n\n\n\n\n END:VEVENT END:VCALENDAR