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:Resources for Quality-Related Activities Systems and Tools Source systems: Clinical systems, EHRs, and so on Decision support systems Data warehousing, analytics, and reporting tools Organizational and executive support Data governance Quality activities Staffing All staff Information technology Analysts, application support, etc. Informatics: CNIO, CMIO Training and education of quality program and use of systems 7
Slide notes:Providers rely on many resources and assets to conduct effective quality activities, including IT, organizational leadership, and staffing. The breadth of IT and software systems used for quality activities depends on the provider size, the type of provider, and the nature of the quality activities engaged in. Small providers naturally may not have the breadth of systems and technology that a large organization may have. In general, an organization can use many technology systems and tools for quality activities. Data collected for quality measures typically comes from source systems, which include clinical information systems; EHRs; radiology, laboratory, and physical therapy/rehabilitation systems; patient care plan systems; and decision support systems, to name just a few. Financial and billing systems can be sources of data as well. Some organizations use data warehouses or similar repository tools to support data aggregation efforts. Analytics and reporting tools are used to support specific quality analysis and reporting activities. Organizational leadership and executive support is critical for a successful quality program for any provider organization. Executive support from the chief of medical staff, chief nursing informatics officer, and chief medical informatics officer is needed because quality is an organization-wide effort. Executives must also engage in the organizations data governance strategies that include [quote] policies and procedures for the business use and technical management of data across the organization. Common goals of data governance are to improve datas quality; remediate its inconsistencies; share it broadly; leverage its aggregate for competitive advantage; manage change relative to data usage; and comply with internal and external regulations and standards for data usage. Data governance is an organizational structure that oversees the broad use and usability of data as an enterprise asset. [end quote] Data governance is critical as quality initiatives move across multiple provider organizations throughout the patient care continuum. Quality initiatives are a matter for all staff. Specific quality studies may involve data around processes, operations, finance, patient satisfaction, or marketing of specific information as well as clinical practice and patient care. Specific quality studies direct not only the data required but the staff that should be involved in the study. Information technology staff is indirectly involved in quality activities through support of source system applications, analytic tools, and reporting tools. Large organizations may have clinical informatics staff or health care informatics staff, including the chief nursing informatics officer and chief medical informatics officer, whose duties include quality initiatives. Training and education for all staff should focus on the organizations overall quality program, the quality initiatives, and staff roles. This is not a one-time education event but an ongoing effort, since quality reporting is an ongoing activity. Very early on, quality activities were supported through use of paper; however, todays quality initiatives require IT, including data source systems, analytics tools, and reporting tools as well as technical staff and informatics staff. Todays complexity of data collection and analytics to support multiple quality initiatives can be effectively handled only with the use of technology. 7