Can Your EHR Improve the Quality of Care You Provide?

More than a few researchers say the EHR can’t improve the quality of care you provide, but Susan T. Andrews, MD, of Family Practice Partners in Tennessee, disagrees. She spoke at the AAFP Scientific Assembly Wednesday, September 17, on how her practice has harnessed the data mining capabilities of its EHR to dramatically improve the quality of care they provide.

In her presentation, “The Roadmap to Quality: How to Use EHRs and Technology to Improve Quality,” Andrews noted that several studies have found that many patients receive care that does not conform to established quality guidelines, citing a RAND study from 2006 that revealed less than 50% of adults in the US receive care that meets recommended guidelines. Andrews stated that, “EHRs allow physicians for the first time to move from providing episodic care to what she called whole patient-oriented quality care.”

Her practice implemented its EHR in 2000 and started participating in the PPRNet quality research project in 2003. She said that they found that the key to harnessing the EHR’s quality improvement potential is to pick one quality indicator, involve the entire staff in brainstorming sessions to identify means of improving that indicator, measure to establish a baseline quality level, implement the change, then measure regularly to monitor efficacy and progress. Andrews referred to this process as “evidence-based management” and shared several examples of best practices her practice has developed over the years.

Physicians and staff should take full advantage of their EHR’s alerts, reminders, inquiries, and recall functions to gain a complete picture of each patient’s health. Andrews also stated that it is essential for practices to use a patient registry software program (she specifically mentioned CINA and the Iowa registry) to enable trend monitoring and long-term guideline compliance tracking. She also suggested incorporating practice guidelines into the record to be available for reference at the point of care. Lab tables, drug/allergy interaction alerts, links to patient ed handouts, messaging, flags, and notes can all be used to improve the coordination of care.

Using the EHR’s ability to compile and link data enables practices to effectively redesign their care delivery system and provide what Andrews called “opportunistic care” that not only improves the health of patients but also potentially the practice’s bottom line (by better meeting performance guidelines). According to Andrews, effectively implementing and using EHR’s data mining can empower physicians to make real and measurable changes in their patient’s health. “Just by using the EHR to better implement what we already know” about disease management, said Andrews, “we will be able to make the biggest positive change in medicine since the invention of penicillin.”