Introduction

1. Physician & Patient Perceptions of Physician Knowledge about Patient Information during Primary Care Visits Paul Smith2, Molly Snellman3, Brian Arndt2, John Beasley2, Roger Brown4, Mary Ellen Hagenauer6, Kate Judge2, Jamie Stone5,6, Bentzi Karsh6, Tosha Wetterneck1 1Department of Medicine, 2Department of Family Medicine University of Wisconsin (UW) School of Medicine and Public Health; 3UW Medical Foundation; 4School of Nursing, 5School of Pharmacy, 6Department of Industrial and Systems Engineering, UW-Madison, WI Introduction Methods • Study design • Randomized controlled trial of a pre-visit planning intervention • Pre-data collection: April – December 2011 • Setting & Participants • 4 Primary care clinics in Southwest/Central WI • 16 primary care physicians, 4 per clinic • 48 - 50 patients age 65 or older per physician • Patient info availability during elderly primary care visits is a safety issue • Scant primary care research on patient & physician perceptions of safety of care & congruency of perceptions • Knowledge of discrepancies is useful to improve the safety and patient centeredness • Survey questionnaire • Post-visit survey for doctors & patients: • 8 Q’s: how much patient info was available for visit • Example: • P: Did this doctor have all the information he or she needed for the visit? • D: Was there information missing from today’s visit? • Question scale: 1=None, 2 = A little, 3 = Some, 4 = Moderately, 5 = Pretty Much, 6 = Very Much, 7 = Completely • Analysis • Responses grouped into 3 info availability categories: 1-2 (low), 3-5 (medium), & 6-7 (high) • Descriptive statistics used to calculate % response in each category for physicians & patients and congruency of response category for each visit • Chi-square used to compare response congruency btw physicians & patients for each visit Research Goal Patient Characteristics • Determine congruency of perceptions btw physicians & elderly patients of physician knowledge of patient information during a primary care visit. Results Conclusions • For over 1/3 of visits, doctors did not have good info on main reason for visit, health concerns, & ongoing medical problems • Doctors & patients agreed about info availability 48-76% of time • Least: health concerns • Most: tests/procedures • Patients thought their doctor had more information than their doctor did for 6 of 8 of the measures • Dramatic for all info needed, ongoing medical prob, health concerns & main visit reason • Patients thought their doctor had less information than their doctor did for 2 of 8 measures • Concerns about costs of care & visits to other health professionals • Physicians often perceive they are missing important clinical information at the end of elderly primary care visits • Patients & physicians agree on how much information the physician had ½ to ¾ of visits • Patients have valuable info that physicians do not have 4-19% of the time, esp. about other health professional visits & the concerns about costs of care • Strategies are needed to get physicians the information they need before elderly primary care visits • Pre-visit planning intervention underway Grant support: Agency for Healthcare Research & Quality R01 , PI: Karsh / Wetterneck