Table 2.

Benefits and Challenges Associated With Adopting Existing Risk Calculation Criteria Versus Developing Novel Criteria

Adopting Existing Criteria (N = 6)Developing New Criteria or Modifying Existing Criteria (N = 9)
BenefitsEvidence-based approachSpecific to patient population
Easy to adoptCustomized weight of criteria
Validated criteriaCan include information external to the EHR
ChallengesNot specific to practice's patient populationRequires clinician and staff input
Lack of clarity in weighting/criteriaTechnical expertise required
May not utilize validated criteria
Explanations“Our Branch Medical Director… and some of our care managers looked at a few different models and felt like this one resonated the most with them… There [were] the appropriate amount of levels that they felt like six levels was a good amount. There were some [models] with fewer, maybe didn't break it out as much.” —Director of process improvement, Practice C0.1“The challenge of the risk tool is finding your population in your community and that you have to know your community to make it. It's not a one size fits all tool. I mean, the criteria will change per the population.” —Nurse manager of care management, Practice F0.2
[AAFP] was already embedded in our [EHR] system, so it was easy to switch over. They had just implemented it, put in [the risk score] as an embedded feature.” —Care coordinator, Practice E0.1“Although there were reasonable approaches, they were… too broad and didn't encompass some of the things that we thought would place a patient in higher risk.” —Physician, Practice G0.1
  • EHR, electronic health record; AAFP, American Academy of Family Physicians.