OPUS-HIT (Outpatient Physician Use and Satisfaction with Health IT) - Nearly 1 billion visits to outpatient clinics occur annually in the United States, supported by a growing array of Health Information Technologies (HIT) intended to improve care quality and safety. The 2009 HITECH Act was instrumental in driving widespread Electronic Health Record (EHR) adoption, with 86% of office-based physicians adopting an EHR by 2017. Subsequent policies have advanced health information exchange, most recently by requiring certified EHRs to include standards-based application programming interfaces (APIs). The Office of the National Coordinator for Health Information Technology (ONC) has played a key role in policy development, implementation, and measuring HIT adoption, use, and impact. Family Medicine is the largest single specialty providing outpatient care. For more than a decade, the American Board of Family Medicine (ABFM) has used its cross-sectional survey of nearly 105,000 Diplomates, with a 100% response rate, to track EHR adoption and Meaningful Use of HIT. Over the last 4 years, the ABFM, the University of California-San Francisco (UCSF) Center for Clinical Informatics and Improvement Research (CLIIR), and ONC collaborated to test and compare survey tools for their ability to inform understanding of the implementation and effects of federal HIT policies. The collaboration built on the unique and nationally representative survey of ABFM Diplomates, refining the survey with input from front-line clinicians in an accompanying qualitative study led by CLIIR. This partnership produced an improved survey and a series of studies about EHR satisfaction, interoperability, and related burden and burnout. This annual survey has proven to be a critical source of insight, given that nearly half of all people who seek care do so only in primary care. The survey achieved a 100% response rate in each of three years, yielding much higher reliability than most prior national EHR assessments. The ABFM aims to inform the policies that affect its physician Diplomates and the patients they serve. The success of this prior collaboration is inspiring other certifying boards to consider doing the same. In the first year of this collaboration, the ABFM proposes to continue supplying highly reliable and nationally representative data about outpatient physician EHR experiences. The ABFM's Center for Professionalism & Value in Health Care will continue to support survey analysis, partnering with other researchers to produce evidence to support better policy. With the American Board of Medical Specialties, the Center has developed an 18-month plan for testing the willingness and capacity of eight additional boards to field similar surveys. Over the next five years, we aim to collect physician feedback more systematically with the goal of informing policy that can improve EHR functionality while reducing burden. We will achieve this by broadening the information base that these assessments rely on by recruiting other certifying boards to collect data in a similar fashion. This partnership will publish and broadly disseminate its findings with the goal of informing the public, patients, and clinician organizations who work with federal agencies to improve care and clinical experience.
