Chapter 14: Quality Care Tracking

Using Health Information Technology to Track Medical Care  

[Understanding Medical Informatics and Outcomes Reporting] 

By Brent A. Metfessel 

You will never understand bureaucracies until you understand that for bureaucrat’s procedure is everything and outcomes are nothing – Thomas Sowell  

Computerized health information technology systems are increasingly being used to analyze the cost-effectiveness and quality of care given by physicians.  A number of third parties show interest in such information, including health plans, Federal and state governments, and consumer groups.  Physicians need clear awareness of the methods used to track their practice patterns, whether the tracking includes the cost of the practice, quality of care (such as frequency of preventive services that a practice provides), or outcomes monitoring.  

Introduction 

Using information systems for such purposes is part of the growing field of medical informatics, which can be defined as the applied science at the junction of the disciplines of medicine, business, and information technology, which supports the healthcare delivery process and promotes measurable improvements in both quality of care and cost-effectiveness (Source:  Medical College of Wisconsin).  Although a number of definitions of medical informatics exist, this definition is the one most relevant to the application of informatics to the tracking of care processes and physician profiling. 

Categories of Data Used to Profile Medical Care Processes 

Having the correct data to support the measures used in practice profiling is key to accurate reporting.  The data must be “clean” and as free from errors as possible.   Errors in the data may occur due to a number of factors, such as poor diagnosis or procedure coding as well as the mis-keying of data fields such as cost values.  In addition, the category of data used needs to match the desired measures that one hopes to obtain.  For example, if a person or organization wants to look at the effect of a congestive heart failure treatment regimen on exercise tolerance, claims data would not be the appropriate source.  Functional status data would need to be collected as well.  The following five data categories are of greatest interest in care profiling.  

More here: BOOK ORDERS [Pre-Release]: http://www.springerpub.com/shoppingcart 

Dictionary of Health Information Technology and Security: http://www.springerpub.com/prod.aspx?prod_id=49952

8 thoughts on “Chapter 14: Quality Care Tracking

  1. Online Patient Registry
    http://www.DocSite.com

    Effective HIT solutions must take into consideration patient safety, aging populations, available broadband and continued healthcare financial pressure, along with the realization that physicians are often computer-savvy.

    This firms’ suite of tools help doctors get paid for the quantity and quality of care delivered by immediately demonstrating clinical value, saving time and improve care. The firm is CMS certified for its alternative Physician Quality Reporting Initiative [PQRI] program that allows its users to qualify for a 1.5 percent Medicare fee-for-service bonus [P4P] by completing and submitting as few as 30 simple preventive care surveys through the DocSite registry.

    Hope

  2. On Providing Evidence Based and Medical Data Driven Solutions
    http://www.DoctorEvidence.com

    This firm is devoted to delivering solutions that address the deficiencies in the evidence-based clinical market. Unlike most “evidence-based” companies that summarize and reference evidence found in clinical studies, Doctor Evidence delivers answers derived directly from the clinical data. This data-driven approach makes it unique while offering a high level of marketplace transparency.

    The company finds, categorizes, stores and converts complex medical information from clinical studies into distributive databases to be delivered in a user-friendly format. A team of clinicians, librarians, and IT specialists work in tandem with medical or lay clients to increase the value of their most important asset: clinical evidence.

    Hope Hetico; RN, MHA

  3. On the Institute for Safe Medication Practices
    http://www.iGuard.org

    This is a patient-oriented website that aims to reduce mix-ups over drug names.

    More than 1,500 commonly used drugs have names so similar to at least one other medication that they’ve already caused mix-ups. And, according to the U.S. Pharmacopeia, at least 1.5 million Americans are estimated to be harmed each year from a variety of medication errors, and name mix-ups are blamed for a quarter of them.

    The Food and Drug Administration [FDA], which currently rejects more than a third of proposed names for new drugs because they’re too similar to old ones, has a pilot program that shifts more responsibility to manufacturers to guard against name confusion.

    iGuard.org is a healthcare service initiative that helps monitor the safety of medications (including prescription drugs, over-the-counter drugs, nutritional supplements and herbal extracts). In partnership with the nonprofit Institute for Safe Medication Practices, the organization sends users email alerts about drug-name confusion.

    Hope Hetico; RN, MHA

  4. The DAP,

    Recall the Dartmouth Atlas Project that has documented glaring variations in how medical resources are distributed and used in the United States.

    The DAP uses Medicare data to provide comprehensive information and analysis about national, regional, and local markets, as well as individual hospitals and their affiliated physicians.

    http://www.dartmouthatlas.org

    Dr. Jim Sibowsky

  5. The IOM Tenth Anniversary

    Balancing “No Blame” with Accountability in Patient Safety

    As some of our readers are aware, this year marks the 10th anniversary of the Institute of Medicine’s report To Err Is Human, the document that launched the modern patient-safety movement.

    A NEJM Essay

    According to Robert M. Wachter MD and Peter J Pronovost MD PhD in a recent [October 2009] New England Journal of Medicine essay, the traditional focus on identifying on who is at fault is a distraction. It is far more productive to identify error-prone situations and settingsm and implement systems that prevent doctors and caregivers from committing errors.

    Link: http://content.nejm.org/cgi/content/extract/361/14/1401

    The Quality Movement

    Although the quality movement has its origins with John E. “Jack” Wennberg MD as the pioneer and leading researcher of unwarranted variation in the healthcare industry – ultimately creating the Dartmouth Atlas of Health Care http://www.dartmouthatlas.org – Bob Wachter is surely the next generation of devotees … Just as surgeon Atul Gawande MD [Brigham and Women’s Hospital, Dana Farber Cancer Institute, and New Yorker magazine] from Harvard Medical School may be among the newest leaders of the movement. And, although it spawned myriad initiatives, the main theme of the movement – drawn from studies of other high-risk industries that have impressive safety records, boils down to this – most errors are committed by good, hardworking people trying to do the right thing.

    Assessment

    As a former Certified Physician in Healthcare Quality [CPHQ], Bob first communicated with me many years ago after his own previous work was mentioned in one of our books. Of course, after he congratulated me on its successful release, he promptly pointed out several typographical errors.

    So, as we ready the launch of the third edition of this Business of Medical Practice [Transformational Health 2.0 Profit Maximizing Skills for Savvy Physicians], I hereby promise Bob to be extra vigilant against such errors and to never take his constructive criticism personally.

    In fact, to know the he even read the book, so carefully, is an honor indeed.

    Dr. David Edward Marcinko; MBA
    [Editor-in-Chief]

  6. Doctor Evidence.com is devoted to delivering revolutionary solutions to address the current deficiency in the evidence-based clinical market. Unlike most “evidence-based” companies that summarize and reference evidence found in clinical studies, Doctor Evidence actually delivers answers derived directly from the clinical data.

    It is this Data-Driven approach that makes Doctor Evidence a unique company, offering the highest level of transparency in the marketplace today.

    More: http://medicalexecutivepost.com/2009/02/04/about-doctor-evidencecom/

    Ann Miller RN, MHA
    [Executive Director]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s