Electronic Health Records and Quality in a Physicians Office

1
Electronic Health Records and Quality in a
Physicians Office

• By Wesley Eastridge, M.D.
• For SMA Annual Scientific Assembly
• November 11, 2005

2
Disclaimer
Owner/partner of Lakes Mercure electronic health
record. Information in this presentation is
generic to all electronic health records programs
and not specific to any one.
3
outline

• Discuss current quality initiatives
• Demonstrate how electronic health records
  improved my practice of medicine
• Caution on reckless use of healthcare information

4
Quality is
5

• The degree to which health services for
  individuals and populations increase the
  likelihood of desired health outcomes and are
  consistent with current professional knowledge.

6
Something wed like to measure Something wed
like to improve
7

• Organizations already profile our practice

8

• Something we dont want someone else measuring
  wrong to penalize us.

9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14

• . The duty of a physician is Rarely to cure,
  often to make better and always to console.
• - A French Physician

15
(No Transcript)
16
morbidity and mortality
17
(No Transcript)
18
(No Transcript)
19
(No Transcript)
20
No more lost charts
21
Organized problem list
22
Less medication errors
23
Remote access
24
Weekend Afterthought
25
Memos
26
Preventive Medicine
27
Guidelines Reminders
28
Guidelines Reminders
29
Quality Indicator Query
30
Quality Indicator Query

• Total patients 612
• 459 within 90 days of last office visit 75
• 341 had a1c lt7, which is 63

31
Drug Recall
32
Referrals
33
Medical Research
34
Quality
35
Into the Future
36
Identification Technology
37
Identification Technology
38
TN / VA Regional Health Problems
39
Care Data Exchange
40
Health Data Exchange
Goofus
Gallant
41
Health Data Exchange
Goofus Computer applications cost money and are
frustrating to learn.
42
Health Data Exchange
Goofus Computer applications cost money and are
frustrating to learn.
Gallant Doctors will order duplicate tests less
because they have all the results available to
them. The chance of adverse medicine
interactions decreases as each prescriber knows
the other prescribers medicines. Doctors can
improve their practice as they get feedback from
quality indicators.
43
Health Data Exchange
Goofus But those quality indicators can be
misleading. One could be penalized with poor
average blood sugar control indicators if they
choose to take care of difficult and
non-compliant patients who dont want to do all
the testing and careful schedules tight sugar
control requires.
44
Health Data Exchange
Goofus But those quality indicators can be
misleading. One could be penalized with poor
average blood sugar control indicators if they
choose to take care of difficult and
non-compliant patients who dont want to do all
the testing and careful schedules tight sugar
control requires.
Gallant Any quality tests we begin with will be
imperfect, but the physician could be given
opportunity to comment on their results, and
there will be many indicators developed over time
which are validated by larger studies.
45
Health Data Exchange
Goofus Who is going to want their medical
information out on the Internet for all the world
to see?
46
Health Data Exchange
Goofus Who is going to want their medical
information out on the Internet for all the world
to see?
Gallant Not for all the world. We have the
technology to effectively restrict that
information to only those who should know. We
can let the patient see their own data, designate
who gets to see it, and revoke permission at
will. They can see a log of who has accessed
their data as well.
47
Health Data Exchange
Goofus Big Brother is watching you! The
government can use this information to dig up
dirt on an opposition politician or an activist
or agitator.
48
Health Data Exchange
Goofus Big Brother is watching you! The
government can use this information to dig up
dirt on an opposition politician or an activist
or agitator.
Gallant Its our responsibility as free citizens
to protect our privacy. We have to put
safeguards to keep administrators or officials
from accessing the data without court orders.
49
And now, this

• Electronic health records are a powerful and
  useful tool for improving our ability to provide
  quality healthcare to our patients.

50
And now, this

• Electronic health records are a powerful and
  useful tool for improving our ability to provide
  quality healthcare to our patients.
• Protection from misuse of information to the
  detriment of the patient or the healthcare
  provider will require vigilance and diligence.