The Population Health Information Technology Assessment (PHITA): Understanding the Ability of Primary Care Practices to Report Clinical Quality Metrics
Rationale Most small-to-medium sized practices lack the software tools and analytic skills required for clinical quality reporting. We describe the development and initial testing of a measure to rapidly assess practices’ clinical reporting readiness and guide technical assistance for population health.
Methods Co-investigators developed the Population Health Information Technology Assessment (PHITA), a 5-point scale comprised of two 3-point sub-scales measuring Software Capability and HIT Skill Set. A practice’s PHITA score was determined by interviewing practice facilitators (PF) who coached practices in a regional quality improvement (QI) study. Relative risk regression models were used to estimate the association between each practice’s PHITA score and its ability to report two or more (of four) cardiovascular risk clinical quality measures (CQMs). A qualitative analysis of PFs’ field notes on high and low PHITA scoring practices was used to describe differences in practices’ HIT experiences.
Results Each point increase in total PHITA score was associated with a 29% higher probability of reporting two or more CQMs. Only 21.4% of practices were found to have the highest score on both sub-scales. Independently owned sites had significantly lower PHITA scores than other ownership types. Qualitative analysis for low PHITA scoring practices revealed reporting challenges and mistrust of data but willingness to try improving quality. High PHITA scoring sites consistently expressed on-going need for assistance, a focus on data accuracy, and greater engagement in quality improvement.
Conclusion The PHITA can help PFs quickly assess preparedness for clinical quality reporting in small-medium sized practices and guide coaching efforts.