Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:Quality Measurement and Improvement
Lecture:Role of IT and informatics
Results of current approaches to quality assessment
Slide content:Role of IT and Informatics Continued In inpatient settings University HealthSystem Consortium (UHC) sites at HIMSS Analytics Stage 4 or higher adoption have higher scores on quality measures (HIMSS Analytics, 2006) Most wired hospitals more likely to have higher quality measures (Weinstock 2015) Mixed results in outpatient settings Presence of EHR not correlated with better quality in treatment of diabetes measures ( Crosson et al., 2007) and general ambulatory quality measures (Linder et al., 2007; Romano & Stafford, 2011) Targeted quality improvement does lead to better outcomes ( Cebul et al., 2011) Better quality not automatic and requires substantial effort (Baron, 2007) 5
Slide notes:There is some evidence that EHR use is associated with better quality, or at least better quality measures, in some settings, particularly inpatient settings. One analysis looked at hospitals in the University Health Consortium, a consortium of academic teaching hospitals. When they looked at sites that had achieved HIMSS [ himz ]or Healthcare Information and Management Systems SocietyAnalytics Stage 4 or higher (that is, had achieved EHR adoption that includes computerized physician order entry and clinical decision support), those institutions were found to have higher scores on quality measures. Since 1994, the HIMSS Nicholas E. Davies Award of Excellence has recognized outstanding achievement of provider organizations that use information technology and EHRs [quote] to substantially improve patient outcomes while achieving return on investment. The Davies Awards program promotes EHR-enabled improvement in patient outcomes through sharing case studies and lessons learned on implementation strategies, workflow design, best practice adherence, and patient engagement. [end quote] Another resource comes from the magazine Hospitals and Health Networks , which [quote] sponsors the annual Most Wired Survey, an industry-standard benchmark study. The survey is designed to measure IT adoption in U.S. hospitals and health systems and is a useful tool for hospital and health system leadership to map their IT strategic plan. Health Forum, an American Hospital Association information company, distributes, collects, and analyzes the Most Wired data and develops benchmarks that are becoming the industry standard for measuring IT adoption for operational, financial, and clinical performance in health care delivery systems. [end quote] The result is an annual Most Wired report identifying the top most wired or technology enriched hospitals in the United States. They found that Most Wired hospitals were more likely than other hospitals to have higher scores on certain quality measures. In outpatient settings, however, the impact of health IT systems on quality improvement is less clear. For example, a few studies have shown that the presence of an EHR didnt correlate with better quality in treatment of diabetes measures and general ambulatory quality measures. Barons advice is useful: Better quality is not automatic and requires substantial effort. 5