Challenges of Defining Quality Care

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Colangelo_0By Dr. Frank Colangelo

A skeptics confession: Five key things I learned about Electronic Health Records (EHR)

One of the biggest opportunities healthcare providers face in defining the quality of care centers on innovation and technology. As a physician, I am the first to admit that I was a skeptic when it came time to implement electronic health records (EHR). Being an extremely busy provider, I did not know how I would find the time to master the system without a wide-scale interruption in my ability to care for the same number of patients.

More than 16 months later, I am astounded by the power EHR offers. Like so many things, the benefits of EHR do not come easily. As our hundreds of employees and providers at Premier Medical Associates work to adopt EHR for our more than 100,000 patients, these are the top five things I have learned thus far.

1). Accept that providers are human

Without a doubt, EHR allows me to be a better doctor than I am on my own. For example, when I am with a diabetic patient, the system guides, reminds and prompts me through a continuous course. Has the patient seen an eye doctor in the last year? Are immunizations up-to-date? Have we checked the feet for signs of neuropathy?

EHR does what no human can. It helps me head off potential problems for my patients, which helps keep them out of the hospital.

2). Ongoing physician leadership is required

The process of taking on EHR involves layers that include investing in the technology, training staff and providers and continuing to monitor progress. This process will not succeed without the long-term leadership of physicians who are consistently involved in a hands-on way. Practices that invest in technology, conduct a training session and assume that their goal has been achieved will not see a positive impact on patient care.

3). A strong vendor partnership is key

As you assess your needs and your investment, it is critical to look for a vendor partner who is strong and will commit to working with your team for the long haul. For instance, our vendor alerted our practice to the availability of a patient registry module that is updated every night and has accompanying alerts for gaps in care as well as the ability to create up-to- date pursuit lists for our practice’s care coordinators.

4). Doctors can say they have EHR and are using it. But meaningful use is what matters for patients. 

For too many doctors, EHR is purchased and used as nothing more than an electronic notepad with a single transcription about a visit being dumped into one field in the system. Yes, this can eliminate handwriting errors and paper files, but what it doesn’t do is unlock the power of information that physicians need to truly bring down cost and drive positive change in healthcare.

The beauty of EHR is that once patient information is properly entered into multiple fields for blood pressure, blood sugar and other key factors, a physician can mine that data. This means that doctors can actually search for patients who are not properly managing their diabetes or are overdue for care, much like you would search for a lost e-mail.

Getting this data to the point where it becomes valuable takes time. But once we have it, this knowledge helps a physician reach people who are falling through the cracks. As a patient, wouldn’t you want your doctor to have this type of power to protect you?

5). It’s a heavy lift, much heavier than you thought 

Embracing EHR in a meaningful way is challenging. It requires more work from staff and providers and more time with patients. For providers who have worked without EHR for years, or even decades, the transition can be cumbersome and painful.

Meaningful use of EHR is a long-term investment. As a former skeptic, I can now see first-hand how EHR drives positive change, but only when providers embrace the hard work it requires.

At the end of the day, this hard work is essential to improving the quality of care and reducing costs. In fact, the future of healthcare depends on it.

Dr. Frank Colangelo is an internal medicine physician with Premier Medical Associates, the largest multi-physician practice in the Greater Pittsburgh area. For more information, visit www.premiermedicalassociates.com or call 412-380-2800.