Related Experiment Video
Updated: Jan 31, 2026
Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
Published on: July 26, 2024
Assessing the Quality of the After-Visit Summary (AVS) in a Primary-Care Clinic
Tasaduq Hussain Mir1, Amimi Osayande2, Kimberly Kone2
1From the Department of Family and Community Medicine, University of Texas Southwestern Medical School, Dallas, TX (THM); Family Medicine Residency Program, Gwinnett Medical Center, Lawrenceville, GA (AO); Department of Family and Community Medicine, University of Texas Health Sciences Center-San Antonio, San Antonio, TX (KK); Department of Family and Community Medicine, University of Texas-Southwestern Medical School, Dallas (KB, PD). Tasaduq.Mir@utsouthwestern.edu.
Background And Objective:
As part of Affordable Care Act, the Centers for Medicaid Services (CMS) recommend physicians provide patients with an After-Visit Summary (AVS) following a clinic visit. Information should be relevant and actionable with specific instructions regarding their visit and health. Until recently, this recommendation was included as part of meeting the standard for Stage 1 Meaningful Use for all physicians using electronic-health-record (EHR) technology. In 2016, CMS issued a Notice of Proposed Rulemaking to institute parts of the Medicare Access and CHIP Reauthorization Act of 2015 Merit-based Incentive Payment System, which continues to focus on quality, resource use, and use of certified EHR technology. The purpose of this study was to assess the usefulness of the AVS for patients seen at the Parkland Family Medicine Residency Clinic.
Methods:
Electronic medical records of 250 randomly selected patients seen at the Parkland Family Medicine Residency Clinic between July 2013 and July 2014 were reviewed using the 3 W's question format, a modified version of the National Patient Safety Foundation's "Ask Me 3 Program," designed to improve communication between patients and their health care providers.
Results:
The goal of the quality improvement study was to ensure that all patients receive a meaningful (relevant, accurate, and actionable) AVS after each clinic visit. Chart review indicated that 100% of patients received an AVS after each clinic visit. Of these patients, 51.2% were Spanish speaking, 47.2% English speaking, and 1.6% spoke neither English nor Spanish. Of the non-English-speaking patients, 84.8% received the AVS in their first language; the other 15.2% received the AVS in English. Sixteen percent (16%) of patients overall were considered to have received a nonmeaningful AVS. Reasons for the AVS not being meaningful included not containing any information on the patient's presenting problem (39.2%), physician intervention (35%), or plan of care (18.4%).
Conclusions:
This study confirmed that although we demonstrate meaningful use of our EHR system, the content of the AVS needs to be improved on.
Related Concept Videos
01:045-Number Summary
In a box plot, the minimum and maximum data values represent the lower and upper whiskers in the graph, and the median is designated as the center of the box in the chart. The first quartile and third...
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:29Angina III: Clinical Manifestations and Assessment
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
01:18Interdisciplinary Care: The Health Care Team-II
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
01:05Quality Control
Quality control helps track data, visualize trends, and identify variations, making it easier to detect deviations that may affect the accuracy of an analysis. One way to do this is by generating a quality control chart, which...