The 1st Annual Crossing the Quality Chasm Summit A Focus on Communities: Report of a Summit (2004) / Chapter Skim
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3 Information and Communications Technology
3 Information and Communications Technology
Pages 37-46
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From page 37... ...
The importance of ICT in both supporting and sustaining quality improvement efforts was a recurring theme throughout the summit. From providing a platform for the exchange of patient information across multiple providers to helping patients in the self-management of their condition, ICT was identified as an enabling force to accelerate system interventions designed to improve care for individuals with chronic conditions.
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From page 38... ...
This initiative includes an emphasis on "preventive maintenance" and the use of ICT to provide decision support for clinicians and actively engage patients. The centerpiece of the program is an electronic scorecard keyed to evidence-based Diabetes Quality Improvement Program (DQIP)
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From page 39... ...
At the point of care, clinician and patient review the results from the scorecard together and use them to make collaborative decisions about the next steps in the care plan. Below is a sample scorecard, which demonstrates that an annual eye exam and blood pressure and LDL cholesterol testing have been completed; however, hemoglobin A1c, ACE Inhibitor, aspirin use, and up-to-date foot exam are still outstanding on this sample patient.
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From page 40... ...
. Copyright 2004 by Michael Dunn.
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From page 41... ...
EHR. They called specifically for a coalition of Promulgating National Data Standards health plans, CMS, consumer groups, organized medicine, and other health care providers to Like participants in the ICT session, the IOM facilitate the adoption of a standardized personal committee that authored the report Patient health record summary whose format would Safety: Achieving a New Standard for Care allow for the transfer of clinical data to any called upon the federal government to be a computer system or EHR, as well as a hardmajor driver in establishing and disseminating copy report in a readable format for paper national data standards (IOM, 2003a)
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From page 42... ...
For example, its use might make it possible to circumvent duplicate laboratory tests, drug interactions, and misdiagnoses attributable to incomplete or missing health records. Additionally, the CCR could serve as a personal health record, helping patients in the self-management of their care.
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From page 43... ...
The challenge is to To justify the expense and time commitment convince consumers that they should be deeply required to integrate EHRs into their practice alarmed about the current state of health care setting, clinicians require empirical evidence quality in the first place. To this end, quality that such interventions as computerized will need to be defined in a way and in terms physician order entry actually do decrease the that are meaningful to consumers as opposed to potential for adverse drug events, or that electronic prompts reminding them to order 43
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From page 44... ...
Participants in the ICT CLOSING STATEMENT session suggested framing health data as a public good and creating a public utility that Most participants in the summit agreed that few would hold the data, making them accessible at innovations in health care delivery are as the community level. The County of Santa promising as ICT, and most acknowledged the Cruz, California, a summit community, is substantial obstacles that have prevented these moving in this direction with its diabetes technologies from becoming standards of care.
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From page 45... ...
To address this problem, two competing private medical groups and the Medi-Cal managed care program have joined the public health department in two initiatives -- the Regional Diabetes Collaborative and the Santa Cruz Health Improvement Partnership -- that bring together front-line professionals from all disciplines and executives to reach consensus on common-ground issues. To date, a web-based decision support system for comprehensive diabetes care has been developed that integrates claims data, laboratory results, pharmacy data, and information generated during office visits.
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From page 46... ...
2001. How can Casalino L, Gillies RR, Shortell SM, Schmittdiel JA, information technology improve patient safety Bodenheimer T, Robinson JC, Rundall T, and reduce medication errors in children's Oswald N, Schauffler H, Wang MC.
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