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) | |
|---|---|---|
| Benefits | Evidence-based approach | Specific to patient population |
| Easy to adopt | Customized weight of criteria | |
| Validated criteria | Can include information external to the EHR | |
| Challenges | Not specific to practice's patient population | Requires clinician and staff input |
| Lack of clarity in weighting/criteria | Technical 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.