Chronic Care: Ehr, Disease Registries Essential for Chronic Care
Posted on: Thursday, 10 February 2005, 03:00 CST
According a report by the California HeaLthCare Foundation, clinical IT systems are essential to improving the quality and consistency of care for people with chronic disease.
The report, "Using Clinical Information Technology in Chronic Disease Care: Expert Workshop Summary," examines the obstacles that have slowed the development, integration and deployment of systems that could improve chronic disease care.
Among the key obstacles are:
* Inconsistent data formats, coding schemes and timing of information delivery in a range of areas, including outcomes, procedures, lab results and pharmacy orders.
* Complexity and cost of matching information about patients that comes from different sources, given the lack of a uniform patient identifier.
DATABYTE
* Incomplete data in existing electronic health information systems, which stymies consistent "maps" of chronic disease states and patients' care.
* Limited functionality in existing disease registries.
CHCF wants to standardize access to and improve the use of clinical information at the point of care. In 2003, it convened an expert workshop to forecast the technology used and how it will be utilized. It conducted that whatever the technology is, most Likely a disease registry or EHR, effective chronic care must include the following functions:
* Identify who in the population has the disease.
* Track one or more outcome measures that indicate how well the disease is being managed (and identify which patients and providers are outliers).
* Track one or more process measures that indicate whether disease management protocols are being observed (and identify outliers).
* Prompt the provider to observe the protocols and to take the required measurements and perform the needed actions.
* Provide feedback to the provider, group or plan about overall performance with a range in reporting for the individual patient Level to the aggregate.
Essential characteristics of the clinical IT systems needed to support those functions include:
* Support for a full range of chronic care processes, specifically outreach to those patients who are missing an aspect of care for their disease.
* A patient-focused and longitudinal approach that identifies and records the complete and current picture of the patient's self-care behavior.
* Application that spans the continuum of care. Clinical IT that reaches from the patient's home to the lab/pharmacy, office/ hospital visits, etc. Ideally, it will be accessible by and useful to the entire care team.
* Real-world applicability that specifically draws on existing data flows or integrates easily into current workflows. It must also be adaptable to fit different conditions, initiatives and approaches to chronic care. And it should replicate common features of paper medical records such as the face sheet that provides essential patient information.
For additional information, visit www.chcf.org.
Copyright Health Forum Inc. Winter 2005
Source: Hospitals & Health Networks
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