QIOs Launch Four-State IT Initiative To Help
Doctors Improve Patient Safety and Quality of Care

Washington, D.C. — Quality Improvement Organizations (QIOs) in California, Arkansas, Massachusetts, and Utah have begun offering a free service designed to overcome some of the biggest challenges to the adoption and effective use of Electronic Health Records (EHRs) by primary care physician practices.

QIOs serve as a national infrastructure for quality improvement in health care. In these four states, QIOs are conducting a two-year pilot of the Doctors’ Office Quality—Information Technology (DOQ-IT) project. Funded by the federal Centers for Medicare & Medicaid Services (CMS), DOQ-IT is developing a national model for accelerating the adoption and use of EHRs as a powerful tool to transform delivery of care—particularly to improve patient safety and management of chronic conditions such as heart failure, diabetes, and hypertension. DOQ-IT focuses on assistance to small and medium-sized physician offices—the majority of primary care practices. Many lack the resources to effectively implement and use EHRs.

A growing number of physicians are using EHRs to more efficiently manage patient information; to avoid adverse events such as drug interactions; to reduce errors by ordering tests and medications electronically; to take advantage of electronic clinical decision support tools; and to automatically generate reminders for immunizations, preventive screenings and diagnostic tests.

But widespread adoption of EHRs in primary care has been constrained by purchasing costs and by lack of assistance for reorganizing clinical systems to improve quality of care using EHRs. Such assistance is often a necessary complement to vendor-supplied technical support. To address this need, QIOs in the DOQ-IT pilot project are offering guidance to help smaller practices:

• Learn about the clinical advantages of using EHRs in managing and improving care;
• Evaluate the risks and potential rewards of implementing IT;
• Assess their practices to see how IT can enhance office efficiency and quality of care;
• Reorganize workflow and care processes to maximize the benefits of IT.
  QIOs are also offering ongoing assistance and extensive networking opportunities to physician practices as they refine clinical processes to take full advantage of EHR capabilities.

“QIO assistance is not just about technology training; it is about major change management with a focus on improving quality, patient safety and efficiency,” said David Schulke, executive vice president of the American Health Quality Association, which represents the national network of QIOs. “With their expertise in systems change and their local relationships with providers and practitioners, QIOs are in a unique position to provide the support that physicians and their office staff need to make this critical transition. Our hope and expectation is that the impact of the DOQ-IT pilot will persuade CMS to ask QIOs in every state to offer physicians this assistance next year.” QIOs work under contract to CMS to improve care for Medicare beneficiaries nationally.

A major goal of the DOQ-IT project is to promote use of EHR systems that provide physicians with data on the quality and results of their care. DOQ-IT will help physicians use EHRs to collect data on a set of quality measures – such as beta-blocker therapy for heart attacks and blood pressure control for hypertension – developed in partnership with CMS, the American Medical Association’s Physician Consortium for Performance Improvement, the National Diabetes Quality Improvement Alliance, and the National Committee for Quality Assurance (NCQA).

“DOQ-IT represents an exceptional opportunity to show how information technology, aided by real-time clinical decision support, can revolutionize the way medicine is practiced,” notes Charles K. Francis, president of the American College of Physicians (ACP), in a letter to CMS Administrator Dr. Mark McClellan. “It also offers the chance to prove the value of evidence-based performance measures. What is learned in DOQ-IT can clearly have national implications, and potentially improve the level and quality of care Medicare provides.” Decision support is a capability of EHR systems that provides physicians with computerized medical knowledge based on thousands of textbooks and journal articles.

The DOQ-IT effort is being led by Lumetra, the California QIO, in partnership with the American Academy of Family Physicians (AAFP) Center for Health Information Technology. Other partners include the American Medical Association, NCQA, ACP, the Leapfrog Group, and the Pacific Business Group on Health. In addition to Lumetra, QIOs working on DOQ-IT are the Arkansas Foundation for Medical Care, MassPRO in Massachusetts, and HealthInsight in Utah.

For more information: Christine Bechtel at AHQA (202-360-1152); Danielle Simmons at Lumetra (415-677-2122); Karen Brazzeal at Arkansas Foundation for Medical Care (479-649-8501 ext 272); Kathleen Iannacchino at MassPRO (781-419-2554), and Sharon Donnelly (801-892-6668) at HealthInsight.

The American Health Quality Association is dedicated to improving the safety and effectiveness of health care. AHQA represents the national network of Quality Improvement Organizations (QIOs) that work with hospitals, medical practices, health plans, long-term care facilities, home health agencies, and employers to encourage the spread of best clinical practices and improve systems of care delivery.