"There are certain things based on strong evidence that we should be doing to take the best care of our patients. The challenge as a physician is making sure you’re meeting those with your patients while at the same time addressing all the things the patient thinks is important."
‒ Dr. James GutierrezCleveland Clinic
In 2007, a group of healthcare providers and payors established Better Health Greater Cleveland, a quality improvement organization under Robert Wood Johnson Foundation's Aligning Forces for Quality initiative. The organization started in the outpatient setting with physician practices, but has recently expanded to include hospitals.
Read the article, featuring Better Health's use of EHR data to identify "Bright Spots" in health care quality.
"If a national vision of value-driven, patient-centered care is to become a reality—one that results in better care, better health of populations, and lower costs—Regional Healthcare Improvement Collaboratives, such as those embodied by the RWJF’s AF4Q initiative, are a necessary part of the solution. Each collaborative represents a neutral common table for all stakeholders to discuss their unique concerns while recognizing their shared interests."
Read the article.
Better Health Greater Cleveland this week joined the Cuyahoga County Health Alliance, a coalition created by County Executive Ed FitzGerald to address improved health for the region, a critical component in the county’s plans for economic development, quality of life and neighborhood revitalization. Mr. Fitzgerald announced the Alliance's new partners April 30, 2012, at a media event in county offices.
Opportunities to improve health in the region are plentiful:
· The county ranked 65th out of Ohio’s 88 counties in health status, in the 2012 County Health Rankings.
· One in five adults in Cuyahoga County smoke, the leading preventable cause of death in Ohio.
· More than one in three adults in the county have high cholesterol
· One of four adults is obese – a trigger for a long list of serious chronic disease.
Better Health is one of 18 organizations and 21 municipalities that do date have responded to Mr. FitzGerald’s “Call to Action” to work together to bring measurable improvement to the health and well-being of Cuyahoga County residents. The Alliance targets public and private policies, education, work-site and community programs and resources to prevent and reduce the burden of chronic disease.
In its role as a partner, Better Health committed to providing community presentations, sharing its clinical expertise and supporting evidence-based programs, policies and benchmarks.
What if health insurers, employers and health care providers banded together to help consumers buy smarter medicine? Don't rule it out. The idea -- the "patient-centered medical homes" model of care -- is beginning to take hold. The next step is to get it off the drawing board and into examining rooms, human resource departments and benefits managers' offices in a much bigger way.
In Northeast Ohio, a group called Better Health Greater Cleveland has been at the task for several years now, advocating among the various stakeholders in both medical care and payment for a shift to medical homes supported by electronic health records. Read more.
A study published in the New England Journal of Medicine is among the first to put hard numbers on the benefits of electronic health records.Researchers looked at four national quality standards, including: 1) Eye exams, 2) pneumonia vaccinations, 3) outcome measures such as blood sugar, blood pressure, and cholesterol control, and 4) patient-driven issues such as obesity and smoking
Nearly 51% of patients in EHR practices received care that met all four quality standards, compared to just 7% of patients at paper-based practices. Nearly 44% of patients in EHR practices met at least four of five outcome standards, compared to about 16% of patients at paper-based practices.
The study is among the first to put hard numbers on the benefits of electronic health records. But as the study's lead author, Randall Cebul, MD, said in an interview this week, "51% is 49% short of ideal."
So what are the next steps? And how can health information technology get us there?
There have been a number of research studies published that question the value of Electronic Health Records (EHRs), particularly as it pertains to improving quality of care and ultimately outcomes. Chilmark has always viewed these reports with a certain amount of skepticism. Simple logic leads us to conclude that a properly installed (including attention to workflow and thorough training) of an enterprise software system such as an EHR will lead to a certain level of standardization in overall process flow, contribute to efficiencies and quality in care delivery and ultimately lead to better outcomes. But to date, there has been a dearth of evidence to support this logic, that is until this week.
Research published August 31 in the New England Journal of Medicine gives cause for optimism that federal investments in electronic health records (EHRs) could reap major benefits in better patient care and health outcomes.