- Quality improvement can be defined in several ways, but federal programs such as the Quality Payment Program tend to define quality based primarily on patient safety and preventable health conditions.
Like many other hospitals and healthcare organizations, Tampa General Hospital is using value-based care as a motivating factor to work with clinical staff to improve quality of care, health outcomes, and patient safety.
Peter Chang, MD, CMIO at Tampa General, recently spoke with EHRIntelligence.com about the benefits of utilizing new technologies in conjunction with Epic EHR for quality improvements in patient care.
“We look primarily at our governing board goals,” said Chang. “They’re made up of a handful of patient safety indicators and a handful of hospital-acquired conditions, which are components of future value-based purchasing models or bundled payments that we’d get either a benefit or a penalty from. So far, it’s strictly reimbursement-driven. We work on what would be most financially feasible. There would be a return on investments not only financially, but also in terms of better outcomes and safer patients.”
Using government incentive programs as a framework for modeling what clinicians should focus on when improving patient care, Tampa General is looking to get more out of its EHR data by laying technologies over the EHR system—in Tampa General’s case, LogicStream—capable of extracting information about care quality that can be made more useful and meaningful for clinicians.
“The data LogicStream is accessing is straight from our Epic database,” noted Chang. “It’s a tool that sits on top of our Epic database that harvests basic things—what orders were enacted, how many medications were dispensed, how many drug-to-drug alerts fired, how many best practices advisories fired.”
Epic provides the raw data for this additional technology to measure outcomes and equip clinicians with the tools to analyze patient safety indicators in their own workflows and improve any necessary measures without manual abstraction.
“Epic has this capability from an IT perspective,” clarified Chang. “However, hospital staff would need to take a report writer and pair him with a clinician, and they would crank through a topic. But that model is not scalable or efficient. Instead, this technology makes it possible to train providers to harvest the structured data and allow for clinical standardization.”
Promoting clinical standardization and enabling providers to analyze and improve quality performance areas pave the way for healthcare organizations to meet federal care quality objectives.
“Anything that simplifies workflow and saves time and effort is going to be the thing that wins in regards to deploying technology out into that field,” added Chang.
While federal policies are what primarily drive clinical objectives regarding quality improvements, Chang posits more definitive guidance would be beneficial to providing clarity to clinicians. Healthcare providers want a better idea of how to make clinical process improvements instead of only knowing what outcomes are expected.
“We’d hope we get better direction from either the government or an EHR vendor,” said Chang. “We’re not getting much in terms of the process of how to achieve objectives—only the expected outcome. It is up to each individual institution to figure out how that is going to get done with an inordinate amount of variability and variables in the process.”
Looking forward, Chang intends to use Epic EHR and additional technologies to become more proactive about meeting quality measures and objectives.
“We are operating in a very reactive state now,” admitted Chang. “But we’re on the verge of using LogicStream to be a little more proactive in how we approach these quality measures. We’re chasing an improvement, but it’s all analyzing old data and trying to implement new processes, documentation, and workflow to help improve the outcome and drive patient safety.”
Combining EHR systems with technology from outside vendors capable of structuring large swaths of data accessible through health databases is already a big step in the right direction toward avoiding overwhelming providers with information. Still, Chang hopes for an even more streamlined future.
“To me, the magic of the whole thing would be if someone created a system that can analyze that data and suggest an outcome,” said Chang. “Right now, it’s a bit of a manual process.”