Health IT Quality

It has been a banner year for healthcare in America, and especially for health IT. Not only have adoption and implementation rates been increasing steadily for e-prescribing, electronic records-keeping and other HIT advances, but policymakers, regulators, administration officials and others more and more are recognizing the value of health IT and its ability to improve patient safety and care quality while reducing healthcare costs overall.

We have seen huge strides in health IT this year, but we still have a ways to go. As we reflect on the past year and all that we achieved, it’s important to also recognize where there is room for improvement – particularly where patient safety and care quality are concerned. As someone who has been leading the charge for improving quality and safety by developing metrics and reporting criteria to measure quality and safety and establishing a set of standards for users to meet, I am always trying to identify ways to improve care quality and patient safety – not only within the Surescripts network, but throughout the healthcare delivery system.

Next year will be a critical year for health IT -- from meaningful use to secure messaging, interoperability to clinical decision support, not to mention the health insurance exchanges and the technological challenges they are anticipated to bring. With all of this in mind and in the spirit of the season, I would like to propose a few New Year’s Resolutions for health IT (they’re easier to stick to than your yearly vow to start going to the gym!).

My Health IT New Year’s Resolutions:

1. Increase e-prescribing and electronic health records adoption amongst providers, pharmacists and others
2. Improve patient access to electronic records
3. Increase interoperability amongst providers, pharmacists, hospital groups and caretakers in order to improve care coordination
4. Empower patients and patient advocates by improving patient engagement
5. Combat alert fatigue
6. Increase e-prescribing of controlled substances
7. Find new ways to incorporate mHealth technologies – particularly to engage patients

What are your New Year’s resolutions for health IT? Tell us below in the comments.

The Surescripts team will definitely be working towards achieving these resolutions in the new year, and making other strides towards improved interoperability, patient safety and care quality, too – so be sure to check back to the HIT Quality Blog for updates on our progress, the latest HIT quality and safety news and more!

And from all of us at the HIT Quality Blog, Happy Holidays!

We have a growing immunization problem in the United States.

Before we get into the severity of the problem, let’s put it in perspective. Just a one percent decrease in the number of children being immunized against illnesses like measles or whooping cough could mean literally hundreds of thousands of potential contagious illness cases that could have easily been prevented. It becomes a major public health issue.

And the fact is, it’s happening right now. Last year, there were over 27,000 cases of whooping cough in the United States, more than double the number reported in 2007. In fact, according to the Infectious Diseases Society of America, we’re seeing 85,000 cases of vaccine-preventable diseases in the U.S. each year – and those are just the cases being reported.

So how do we get a handle on this problem? How do we better identify the households in which children are not getting recommended vaccinations? How do we make certain parents are properly informed about the vaccines their children should be receiving? For that matter, during flu season, how can physicians be assured that their patients are receiving protective flu shots?

The potential exists for a data network, not unlike Surescripts’ national interoperable network, to address this challenge.

A Surescripts survey of physicians found that a major contributing factor is the difficulty of maintaining complete medical records. Nearly 39 percent of doctors said they are frequently missing immunization records when they see patients.

Paper-based records can’t handle the problem. Paper doesn’t allow the rapid, unfettered movement of patient information between physicians, hospitals, clinics, nurses and other healthcare professionals who see patients and can advise on vaccination issues. Electronic data enables the presence of a complete medical record every time a patient interacts with the healthcare system. Therefore, when a child has not received a recommended vaccination, that can be flagged and protocols can be put in place to automatically alert physicians and parents accordingly.

At Surescripts, we’re already putting this theory into practice. This past March, we entered into an agreement with Walgreens. All of the nearly 8,000 Walgreens and Duane Reade pharmacies and the company’s 350 Take Care Clinics^TM, located in many of its stores, will use the Surescripts network to provide immunization reporting to primary care providers as well as state and local public health agencies.

This is just the beginning of a process that will one day allow every healthcare professional to not only know what care a patient has received but, just as importantly, what they have not.

The protection of public health depends on using every tool available to us to guard patients from preventable, communicable diseases. A comprehensive data network is one of these tools, and another one of the ways that health IT stands to improve public health in this country.

“With the push of a button…..”

That’s a phrase we’ve heard used countless times in the decades since push-button technology was invented and used for everything from televisions to kitchen appliances.

But pushing a button has now taken on a much more important and profound meaning for our lives, health and wellness.

The Blue Button initiative was launched in 2010 by the Department of Veterans Affairs (VA) to give military veterans the ability to retrieve, download and print all of their medical records with, yes, the push (or click) of a button on a computer screen.

This was a tremendous development. For military veterans, many of them with multiple and complex health issues and having been treated by several healthcare professionals in various locations, it is extremely advantageous to have all of their health records in one place where they can be provided to the physician currently treating them. This ensures more reliable and effective healthcare and also enables the veterans to update their own files.

It didn’t take long for the private sector to take notice. Large insurance providers like UnitedHealthcare, Aetna and Kaiser Permanente began to adopt the “Blue Button” approach, giving their customers greater control over their own health information.

This revolution, though, is far from over.

The partnership between Surescripts, with the nation’s largest interoperable healthcare data network, and Epic’s Care Everywhere platform, which holds medical information for approximately 150 million patients, creates an opportunity to take the “Blue Button” approach to an entirely new level.

We will now have the ability to transmit patient-specific information for nearly half of the healthcare consumers in the United States to providers across multiple technology platforms. This will vastly increase a patient’s (or provider’s) capability to keep all of a patient’s records – no matter how many healthcare professionals they’ve seen, even if they’re in various, disparate locales – easily accessible in one place. There is a tremendous feeling of security knowing that all of your medical information is just one click away, and there is a tremendous opportunity for improvement in healthcare quality when physicians can be assured they know everything they need to know about the patient they’re treating.

Our nation has a long history of adopting its medical best practices from those procedures being practiced at the front lines of battle. As the Blue Button initiative suggests, even the procedures and practices our nation’s armed forces’ and veteran’s healthcare providers are utilizing at home are worth following.

Recently, I sat down with EHR Intelligence Editor Kyle Murphy to discuss the Surescripts E-Prescription Network, the recent rise of e-prescribing adoption and utilization, challenges facing expanded use, network interoperability, data security and more. Head over to EHR Intelligence to read the full interview by clicking here.

In a recent article in FierceEMR, the idea of improving data quality through patient review of their own information was raised. I think this is one of the simplest and smartest ideas I have heard in a long time. I say this for two reasons.

The first reason is my observation that data which is not reviewed will have quality problems which will go undetected. Only when data is actively reviewed and validated do we find that errors or omissions are caught. Of course finding problems is only one part of a quality improvement cycle. But it is a necessary first step. Once problems are found, they need to get corrected, but that will not happen if the problems are not found.

Secondly, the patient is in a great position to review their own data. As long as the information is not clogged with arcane codes and terminology, patients inherently know what procedures and issues are theirs and which are not. No one knows my health status and history better than me. And beyond knowing what I have had in the past, I am pretty clear on what I have not had or what looks questionable.

Patients should not be the first line of defense on accurate health data. The system that results in patient data being gathered and stored needs it's own quality systems and checks and balances. But as a final check and a last line of defense, patients (or their custodians) should be exposed to their own information for quality review purposes.

When and where can I get mine?