Feasibility of Patient Navigation and Impact on Adherence to Screening Colonoscopy in a Large Diverse Urban Population.

Introduction: Disparities observed in colorectal cancer (CRC) incidence and mortality among blacks and Hispanics compared with whites may be in part due to lower screening rates. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has implemented a patient navigator (PN) program at NYC hospitals serving lower-income patients to promote high adherence by patients referred for screening colonoscopy. A prior study showed this PN program increased adherence at 3 public hospitals.

Effect of Physician Participation in a Multi-element Health Information and Data Exchange Program on Chronic Illness Medication Adherence.

Background: The Primary Care Information Project (PCIP) includes a network of more than 10,000 physicians across New York City focusing on improving the quality of patient care through the use of health information technology and data exchange.

Methods: We assessed adherence, defined as the percentage with a medication possession ratio (MPR) ≥80%, across 2 time periods for union members whose primary care providers participated in the PCIP compared with those whose providers did not participate. Using prescription claims data from 2008 and 2011, the MPR was calculated for disease-specific categories of drugs among patients with diabetes, hypertension, and both conditions.

Effect of pay-for-performance incentives on quality of care in small practices with electronic health records: a randomized trial.

Importance: Most evaluations of pay-for-performance (P4P) incentives have focused on large-group practices. Thus, the effect of P4P in small practices, where many US residents receive care, is largely unknown. Furthermore, whether electronic health records (EHRs) with chronic disease management capabilities support small-practice response to P4P has not been studied.

Early assessment of health care utilization among a workforce population with access to primary care practices with electronic health records.

This study assesses the health care costs and utilization among labor union members from 2008 to 2010 and compares whether members accessing primary care providers participating in a public health city program, the Primary Care Information Project (PCIP), had different health care usage or cost patterns. Using claims data, the number of hospital inpatient services utilized decreased by 16 per 100 members among those with chronic conditions accessing PCIP providers, whereas members seeing non-PCIP providers increased by 15 per 100 members. Access to providers participating in a population health initiative was associated with lower utilization of inpatient services and overall costs.

Patient experiences at primary care practices using electronic health records.

We assessed patient experiences before and one year after electronic health record (EHR) implementation among primary care practices in New York City. These practices represented an ethnically diverse population in lower-income, urban communities. Surveys, available in English, Spanish, and Chinese languages, were administered at 10 sites.

Tracking the delivery of prevention-oriented care among primary care providers who have adopted electronic health records.

The Primary Care Information Project is a New York City initiative aimed at improving population health through the improved delivery of preventive care. It has assisted with the adoption of a fully functional electronic health record (EHR) in over 300 primary care practices. Practices with EHRs automatically transmit summary data that can be used to track population health indicators for recommended preventive care.

Associations between ozone and daily mortality: analysis and meta-analysis.

Background: There is ample evidence that short-term ozone exposure is associated with transient decrements in lung functions and increased respiratory symptoms, but the short-term mortality effect of such exposures has not been established.

Methods: We conducted a review and meta-analysis of short-term ozone mortality studies, identified unresolved issues, and conducted an additional time-series analysis for 7 U.S.

Contribution of respiratory disease to nonrespiratory mortality associations with air pollution.

Many time series studies have found that individuals with primary cardiac conditions were susceptible to the adverse effects associated with increased ambient particle levels. However, the mechanism(s) of these associations is not yet understood. In this study, we evaluate whether individuals with nonrespiratory primary causes of death who also had contributing respiratory causes listed on their death certificates were more affected by air pollution, as compared with those not having contributing respiratory conditions.