quality improvement introduction to quality improvement and health information technology lecture a...

Quality Improvement

Introduction to Quality Improvement and Health Information Technology

Lecture a

This material (Comp12_Unit1a) was developed by Johns Hopkins University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000013.


Learning Objectives─Lecture a

• Identify the current challenges in healthcare quality.

• Examine the components of the healthcare system that have an impact on quality.

2Health IT Workforce Curriculum Version 3.0/Spring 2012

Quality Improvement Introduction to

QI and HIT Lecture a

Current Healthcare Landscape: Affordable Care Act




Systems and Healthcare Reform

“Healthcare reform without attention to the nature and nurture of healthcare as a system is doomed …It will at best simply feed the beast, pouring precious resources into the overdevelopment of parts and never attending to the whole — that is care as our patients, their families and their communities experience it.” (Berwick, 2009)

“The performance of a system — its achievement of its aims — depends as much on the interactions among elements as on the elements themselves. (Berwick, 2009)

“The improvement of health and healthcare depends on systems thinking and systems redesign… ‘Reform’ without systems thinking isn’t reform at all.” (Berwick, 2009)




Current Healthcare Landscape

MEANINGFUL USE

Providers show they're using certified EHR technology in

ways that can be measured significantly in quality and in

quantity.

PATIENT-CENTERED MEDICAL HOME

Providers organize care around patients, working in teams,

coordinating care, and tracking over time.

ACCOUNTABLE CARE ORGANIZATION

Provider reimbursements are tied to quality metrics and

reductions in the total cost of care for assigned population of patients.




Meaningful Use and QI

“Even hospitals with fully functioning EMRs still make extensive use of digitized scans of manually completed forms and textual checklists. With no forms or screens to capture data in a structured way, hospitals fail to report quality measures as a routine byproduct of the practices, relying instead on a retrospective chart abstracting process.” (Holland, 2010)




Meaningful Use and QI

• The American Reinvestment and Recovery Act of 2009 “…authorizes the Centers for Medicare & Medicaid

Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals who are successful in becoming ‘meaningful users’ of certified electronic health record technology …” (The American Reinvestment and Recovery Act of 2009)

• The HITECH (Health Information Technology for Economic and Clinical Health) Act establishes programs under CMS in coordination with the Office of the National Coordinator to accomplish this charge.




Goals of Meaningful Use

• Improve quality, safety, & efficiency

• Engage patients & their families

• Improve care coordination

• Improve population & public health; reduce disparities

• Ensure privacy & security protections







Meaningful Use Stages

The Patient Centered Medical Home (PCMH)

• The Patient Centered Medical Home (PCMH) is “an approach to providing comprehensive primary care for children, youth and adults. The PCMH is a healthcare setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family.” (Patient-Centered Primary Care

Collaborative)




Joint Principles of the Patient-Centered Medical Home

• American Academy of Family Physicians (AAFP)

• American Academy of Pediatrics(AAP)

• American College of Physicians (ACP)

• American Osteopathic Association (AOA)

7 Principles of the PCMH




Seven PCMH Principles

• Personal physician

• Physician-directed medical practice– Collective responsibility

• Whole person orientation– All stages of life, all sites of care

• Coordinated and integrated care– Assures smooth, continuous, and culturally

appropriate care




Seven PCMH Principles

• Quality and safety– Optimal patient-centered outcomes; evidence-based

practice; CQI; use of CDS; measuring achievement of outcomes, etc.

• Enhanced access– Ease of access to providers

• Payment– Recognizes value of the PCMH

• Coordination, Health IT, Remote Monitoring, Attention to Case Mix, Physician Share in Cost Savings; Payment for Quality




Patient Centered Medical HomeNCQA Scoring Tool




Accountable Care Organizations





Summary─Lecture a

• The quality of care received in the US needs improvement.

• In the current healthcare environment there are a number of initiatives that aim to improve the care for all Americans through the use of HIT.• Meaningful Use

• Patient Centered Medical Home

• Accountable Care Organization





References—Lecture aReferences• Affordable Care Act. Available from: www.healthcare.gov/law/index.html• Berwick, D. October 30, 2009, speech, Harvard School of Public Health• Center for Medicaid Services. Shared Services Program. Available from:

https://www.cms.gov/sharedsavingsprogram/• Endorsing national consensus standards for measuring and publicly reporting on performance; California Academy

of Family Physicians Diabetes Initiative Care Model Change Package originally developed by Lumetra • Holland, Marc. In Health Information Exchange: From Meaningful Use to Healthcare Transformation. Available

from: http://www.himss.org/content/files/Carefx%20_HIE_meaningful-use2.pdf• The National Coalition on Health Care (NCHC, 2007). Available from: http://nchc.org/

Patient-Centered Primary Care Collaborative. What We Do (PCMH). Available from:

http://www.pcpcc.net/what-we-do• Patient Protection and Affordable Care Act (PPACA). Available from: http://www.healthcare.gov/law/index.html• President Barack Obama. Barack Obama, speech at George Mason University, January 12, 2009• U.S. Department of Health and Human Services. (June 22, 2011). Up to $500 million in Affordable Care Act

funding will help health providers improve care. Retrieved from: http://www.hhs.gov/news/press/2011pres/06/20110622a.html

Charts, Tables, Figures

1.1 NCQA Scoring Tool. Produced by the National Committee for Quality Assurance. Available from: http://www.ncqa.org/LinkClick.aspx?fileticket=AHJ2EF4pH6Y%3d&tabid=631&mid=2435&forcedownload=true





References—Lecture aImages

Slide 5: Meaningful Use, Patient-Centered Medical Home, Accountable Care Organization. Courtesy of Dr. Anna Maria Izquierdo-Porrera

Slide 9: Meaningful Use Stages. Courtesy of Dr. Anna Maria Izquierdo-Porrera




quality improvement introduction to quality improvement and health information technology lecture a...

Documents

improvement of health

healthcare quality

department of health

quality metrics

quality measures

clinical health act

workforce curriculum

healthcare system