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GAPS in Implementing Health Assessments in Primary Care: A Literature Review

James, Katherine A. MSCE, PhD; Fernald, Douglas H. MA; Huff, Jessica MA; Ross, Steven MD; Staton, Elizabeth W. MSTC; West, David PhD; Ricciardi, Richard PhD, NP, FAANP

The Journal of Ambulatory Care Management: January/March 2014 - Volume 37 - Issue 1 - p 2–10
doi: 10.1097/JAC.0000000000000000
Original Articles

Patient-reported health data are critical components of patient-centered health care. However, barriers related to acquisition, implementation, and data use have not been well characterized. We conducted a systematic review of literature about health assessments in ambulatory and primary care covering 2 domains: (1) best practices in health assessments in primary care and (2) integration of health assessments into electronic health records. Our review found that training and standardization of practice workflows improves implementation of health assessments; however, gaps remain on identification and selection of health assessments, integration with electronic health records, and optimal intervals of health assessments administration.

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Department of Family Medicine (Drs James and West, Mr Fernald, and Mss Huff and Staton) and General Internal Medicine (Dr Ross), University of Colorado Denver, Anschutz Medical Campus, Aurora; and Center for Primary Care, Prevention and Clinical Partnerships, Agency for Healthcare Research and Quality, Rockville, Maryland (Dr Ricciardi).

Correspondence: Katherine A. James, MSCE, PhD, Department of Family Medicine, University of Colorado Denver, Mail Stop F443 13991 E Montview Ave, Aurora CO 80045 (

The authors certify that the submission is original work and is not underreview at any other publication. This manuscript is based on research conducted by the Department of Family Medicine at the University of Colorado School of Medicine under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland (contract no. HHSA29020071008). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the US Department of Health and Human Services.

All coauthors have seen and agree with the contents of the manuscript, and there is no financial conflict of interest to report.

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