Helping Physicians Adopt and Use IT for Better Care
Quality Improvement Organization Goals: 2005-2008
Under a new
three-year contract with the Centers for Medicare & Medicaid
Services (CMS), the national network of Quality Improvement Organizations
(QIOs) will begin in mid-2005 to help physicians assess the benefits and
overcome barriers to adopting and using Electronic Health Records (EHRs)
and other health information technology (HIT).
Health information technology such as e-prescribing, electronic management
of lab results, electronic medical image storage and transmission, and deployment
of full electronic health records has significant potential for improving
care in ambulatory settings, where most patient care is provided.
In addition, integration of EHRs into electronic health information networks
will allow for improvement of quality of care on a broad scale, as well as
better surveillance of threats to public health.
How QIOs Will Accelerate Adoption and Effective Use of Physician-Office
HIT
Widespread adoption of EHRs and other health information technology in
ambulatory care depends on overcoming major barriers, particularly understanding
the cost of purchasing systems and the need for expert guidance in using
these systems to improve care.
This year,
QIOs will begin working to jump-start the process by assisting the practices
that often need the most help—mainly smaller and medium-sized
practices that make up the majority of primary care practices in America
.
QIOs will encourage adoption of HIT by helping physicians learn about the
clinical and administrative advantages of using EHRs for managing and improving
care. QIOs will help physician practices assess their readiness to adopt
HIT systems and offer guidance on the costs and benefits of selecting a system.
QIOs will also help physician offices evaluate and redesign office workflow
and care processes to effectively use EHRs and other HIT to improve efficiency,
quality and patient safety in their every day work, including implementation
of more effective chronic care management and patient self-management of
chronic conditions. Office workflow and care process redesign is one of the
most challenging aspects of implementing HIT.
Significantly,
QIOs will work with physicians to “get it right the
first time,” so that difficulties adopting HIT systems do not cause
physicians to abandon efforts to use HIT effectively. However, QIO assistance
to physicians is not intended to supplant technical support from vendors
of EHRs and other HIT systems. QIOs will complement vendor-supplied support
by providing ongoing guidance on how to use EHRs to improve clinical performance.
How Doctors
Can Use HIT For Better Quality Care
Around the country, many physicians are already effectively using HIT systems
and EHRs to:
- Facilitate better management of care for patients with chronic conditions
such as diabetes, coronary artery disease, heart failure, arthritis, and
hypertension.
- Provide more rigorous preventive care by generating reminders for immunizations,
preventive screenings, and tests.
- Avoid adverse events such as drug interactions by tracking patient medication
data.
- Reduce errors and delays due to lack of easy access to patient records.
- Improve patient-clinician communication.
- Reduce variation in care across patient populations.
- Access continuously updated clinical decision support tools and data.
- Store and easily access patient test results and reports from specialists
and other doctors.
How QIOs Will Help Doctors Use IT To Measure and Report on Quality of
Care
HIT systems can help physicians collect data to analyze the overall quality
of care delivered by their practices. For example, data on how often ph ysicians
use recommended practices for the treatment of common chronic conditions
or provide preventive services can be an invaluable guide to improving care.
QIOs will show physicians how to use HIT to get this data.
In each state, QIOs will help a group of physicians collect data and report
their performance on the full set of Doctors Office Quality measures (available
at www.doqit.org) developed by 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). These physician office quality
of care measures include:
- Biennial retinal exams, annual blood sugar testing, and biennial lipid
profile testing for management of diabetes.
- Biennial mammography for breast cancer detection.
- Flu and pneumonia immunizations.
- Blood pressure screening and control for hypertension.
- Cholesterol screening for heart disease management.
- Beta blocker therapy for heart attack victims.
QIOs will help physicians use this data to improve processes of care by
implementing care management that incorporates planning, assessment, coordination,
evaluation of treatment options and monitoring of care to meet the needs
of individual patients.
Assistance to physicians will complement QIO work with hospitals to support
adoption and use of computerized physician order entry, bar coding, and telehealth
technologies with the goal of improving readiness and/or use of IT.
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. Visit: www.ahqa.org.
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