Table 3.

Selected focus group comments from participating rheumatologists.

Provider education“I feel I have limited mastery and when my mastery is limited I’m sometimes skeptical about intervening. Because I might not do it right.”
Scope of practice“From a broader perspective, really prior to this intervention and for many, many years, my view is that my scope of practice doesn’t really include preventive things… I’m sort of redefining scope a little, [but] this is not my area. I’m being dragged kicking and screaming into this.”
EHR challenges“I gave up about a month into it. I couldn’t figure it out. Every time I would end up going around and around and around. I gave up. When I gave a vaccination I would just tell the RN to give an injection and document it.”
Patient barriers“Patients hem and haw — ‘I need to go check with my primary care provider.’ Or they say, ‘I’m going to get it at Walgreens [pharmacy].’ And then when they come back, they haven’t.”
Coordination of care“One of my concerns is always coordination of care. What am I going to do with these results? If they are abnormal, [I] want to make sure they’ll see their internist. I never know how to make sure that happens.”
Performance reports“After realizing I’m terrible, I realized I wanted to get better. They provided motivation to improve. And it didn’t get as good as I would have liked, but it did improve.”
  • EHR: electronic health record; RN: registered nurse.