What Factors Limit Health IT’s Ability to Support Quality Measurement and Quality Improvement?
by Janice Nicholson, Co-Founder, President & CEO, i2i Systems, Inc.
Twitter: @i2isystems
This is an extremely important question to which my response is based on field experience in supporting hundreds of clinics and practices that are using more than 30 different Practice Management (PM) or Electronic Health Record (EHR) systems. I would like to tell you that we have figured out why health IT investment has not resulted in more dramatic improvements to outcomes of care and that we have the solution, but we do not. What I can share with you are three of the primary challenges we have experienced in helping organizations realize the benefit of health IT adoption.
Interoperability
The first challenge surrounds standards and interoperability. EHRs claim they interoperate, but what they don’t say is at what level. Much of the data in EHRs about patients is customized, unstructured data. Even within the same EHR, templates allow a patient’s medical data to be stored in different locations of the database with different representations. This means that while the definition is the same, the information available is not. This lack of EHR vendor standardization and inability to share customized, unstructured data cripples efforts to address Meaningful Use (MU) and severely limits the analytic capability of EHR data.
Meaningful Use Support
The second challenge is that EHRs do not fully support MU requirements. Health IT analytic capabilities are currently not evolved enough to support tactical, operational and strategic population health management for continuous improvement. This challenge hampers organizational leadership, management and care teams in proactively monitoring and improving performance. To meet MU Stage 3, organizations need tools that will support long-term, sustainable change.
Lack of Incentive
The third challenge is lack of incentive to achieve higher levels of performance. We often see organizations drawn to our population health management solutions for required reporting to payers. We encourage organizations to leverage our tools to their fullest abilities, but many are satisfied with threshold performance since there are not enough incentives to drive performance. This speaks to the lack of a data-driven culture incented to measurably improve health outcomes.
While these challenges are prevalent, fortunately, they do present some opportunity.
First, health IT vendors must provide clinics open access to their data, and remove barriers to standardization and interoperability. Performance can then be measured in a reliable way and shared across the health system.
Second, we need to face the reality of what EHRs currently deliver. There is no single, comprehensive, all-inclusive health IT solution that will meet everyone’s needs today and in the future. We have to help providers understand the intelligence tools they need so they can plan and budget for what will be required to monitor, improve and sustain health outcomes.
Third, we need to increase the percentage of revenue directly related to Pay for Performance. Organizations need to be incentivized for behaviors that drive change. This will naturally catalyze the quality lifecycle that results in high performance.
We can be optimistic if we address these opportunities. Success is within our grasp and it can come at a price that everyone can afford.
This article was originally published on i2i Systems and is republished here with permission.