Clinical-Community Relationships Measures (CCRM) Atlas

Exhibit 5-17. Measure 17: Referral rate for intensive counseling from a community program

Domain:Referral processElement/ relationship:Clinic/ clinician-patient
Instrument:N/A
Purpose:An electronic linkage system (eLinkS) tracked the promotion of health behavior counseling and automation of patient referrals to community counseling services. This measure calculated the proportion of all patients with risk factors referred for intensive counseling.
Format/data source:Electronic health/medical record. Utilizing the electronic medical record as a platform, eLinkS was designed to (1) help clinicians systematically perform elements of the 5A's that are feasible in busy practice settings (i.e., asking about health behaviors, offering brief advice, and agreeing on next steps); (2) make it fast and easy to refer patients to intensive counseling outside the office; and (3) establish bidirectional communication between practices and community counselors.
Measure type:ProcessDate:2008
Preventive service/ USPSTF:Alcohol Misuse Counseling; Healthy Diet Counseling; Obesity Screening and Counseling—Adults; Tobacco Use Counseling and Interventions—Non-Pregnant
Clinical practice:Primary Care—Family Practice; Primary Care—Internal Medicine
Denominator: Patients who reported they wanted to address an unhealthy behavior and engaged to address the unhealthy behavior (A1-A3)
Numerator:Number of patients referred to intensive counseling (A4)
Development & testing:Prompts of the eLinkS were applied to the 5A's of health behaviors.
Past or validated application:Nine primary care practices in the Tidewater region of Virginia were recruited. The practices, members of a single medical group and of the Virginia Ambulatory Care Outcomes Research Network (ACORN), share a common type of EMR (GE Centricity Physician Office©) that is managed by a central informatics staff. The practices have used the EMR for 3 to 10 years. Practice size ranged from 1 to 30 clinicians (median = 3), and 48 (87%) clinicians participated in the study. Two sites were solo practices, five had three clinicians, one had eight clinicians, and one (a family medicine residency program) had 30 part-time clinicians and residents.
Citation(s):Krist, A. H., Woolf, S. H., Frazier, C. O., et al. An electronic linkage system for health behavior counseling effect on delivery of the 5A's. American Journal of Preventive Medicine (2008) 35:S350-S358.

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Page last reviewed March 2013
Internet Citation: Clinical-Community Relationships Measures (CCRM) Atlas: Exhibit 5-17. Measure 17: Referral rate for intensive counseling from a community program. March 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/resources/clinical-community-relationships-measures-atlas/ccrm-atlas-ex517.html