Major Disruptive Events Over 2 Years, Pre- and Postenrollment (N = 208 Practices)
| Event | Practices Affected, No. (%) | No. of Unique Practices With MDEs | |
|---|---|---|---|
| Preenrollment | Postenrollment | ||
| Lost 1 or more clinicians | 59 (28) | 33 (16) | 79 |
| Lost 1 or more office managers or head nurses | 38 (18) | 14 (7) | 51 |
| Moved to a new location | 9 (4) | 8 (4) | 17 |
| Purchased by or affiliated with a larger organization | 1 (<1) | 4 (2) | 5 |
| Implemented a new EHR | 33 (16) | 15 (7) | 43 |
| New billing system | 35 (17) | 15 (7) | 42 |
| Total unique practices with major disruptive events | 120 (58)a | 67 (32)b | 137 |
EHR = electronic health record; MDE = major disruptive event.
Note: Data on preenrollment MDEs were collected via surveys of practice managers and staff who reported retrospectively on MDEs that occurred within 1 year before study enrollment. Postenrollment data on MDEs were obtained prospectively through reports entered by practice facilitators as they observed workflow in assigned practices. In all, 120 unique practices experienced at least 1 MDE during preenrollment, and 67 unique practices reported at least 1 MDE postenrollment. During the 2-year period, 137 unique practices of the sample of 208 had at least 1 disruptive event.
↵a Forty-two practices experienced more than 1 MDE during the preenrollment period.
↵b Twenty practices experienced more than 1 MDEs during the postenrollment period.