Cerner Millennium's Care Pathways for Specialty Care Referrals: Provider and Nurse Experiences, Perceptions, and Recommendations for Improvements.

Background: Using structured templates to guide providers in communicating key information in electronic referrals is an evidence-based practice for improving care quality. To facilitate referrals in Veterans Health Administration's (VA) Cerner Millennium electronic health record, VA and Cerner have created "Care Pathways"-templated electronic forms, capturing needed information and prompting ordering of appropriate pre-referral tests.

Objective: To inform their iterative improvement, we sought to elicit experiences, perceptions, and recommendations regarding Care Pathways from frontline clinicians and staff in the first VA site to deploy Cerner Millennium.

Interdisciplinary Priorities for Dissemination, Implementation, and Improvement Science: Frameworks, Mechanics, and Measures.

Much of dissemination, implementation, and improvement (DII) science is conducted by social scientists, healthcare practitioners, and biomedical researchers. While each of these groups has its own venues for sharing methods and findings, forums that bring together the diverse DII science workforce provide important opportunities for cross-disciplinary collaboration and learning. In particular, such forums are uniquely positioned to foster the sharing of three important components of research.

Percutaneous vertebroplasty and kyphoplasty for pathologic vertebral fractures in the Medicare population: safer and less expensive than open surgery.

Purpose: To compare cost and outcomes of surgical and percutaneous treatments of pathologic vertebral fractures.

Materials And Methods: Standard Medicare 5% anonymized inpatient files (1999-2009) were retrospectively reviewed. Patients with a diagnosis of vertebral fracture without spinal cord injury and primary or metastatic bony malignancy were divided into percutaneous or surgical groups based on whether they received vertebroplasty/kyphoplasty or surgical treatment.

Promoting electronic health record adoption among small independent primary care practices.

Objectives: To describe the benefits and limitations of incentive arrangements used to engage small primary care practices to adopt electronic health records (EHRs).

Study Design: Retrospective review of program outreach efforts and EHR enrollment rates.

Methods: Comparison of benefits and limitations of various promotional strategies in addition to a city subsidy.