Presentation is loading. Please wait.

Presentation is loading. Please wait.

Unit 1c: Relationship of QI and HIT Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department of Health.

Published byErik Davis Modified over 9 years ago

Similar presentations

Presentation on theme: "Unit 1c: Relationship of QI and HIT Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department of Health."— Presentation transcript:

1 Unit 1c: Relationship of QI and HIT Introduction to QI and HIT This material 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.

2 Objective Analyze the ways that HIT can either help or hinder quality improvement Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 2

3 The best care At the lowest cost For the whole population Improve individual experience Improve population health Control inflation of per capita costs D. Berwick, Institute of Healthcare Improvement, 2007 Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 3 IHI Triple Aim and HIT

4 The best care At the lowest cost For the whole population Introduce information tools into clinical practice Electronically connect clinicians to other clinicians Use information tools to personalize care delivery Advance surveillance & reporting for population health improvement Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 4

5 IOM Aims and HIT Safe Effective Patient-centered Timely Efficient Equitable Health care should be: Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 5 Image: Amazon.com

6 Benefits of HIT Improvement of patient safety, efficiency, effectiveness, equity, timeliness, and patient- centeredness. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 6 Image: MS Clipart

7 Enhancing Patient Safety with HIT CPOE e-MAR Computerized provider order entry Can reduce errors in drug prescribing and dosing Computerized medication administration record Can reduce errors in drug administration Medical Device Interfacee-Allergy List Automated vital sign capture Can reduce errors in transcription Computerized allergy list Can reduce errors in preventable adverse drug events Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 7

8 Enhancing Patient Safety with HIT Knowledge LinksReminders Reference information links Can reduce errors due to lack of knowledge Prompts and flags Can reduce errors in omission Monitoring Structured Notes Quality metric reporting Can identify opportunities for improvement Standardized observations Can reduce errors related to failure to detect subtle changes in status Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 8

9 Enhancing Clinical Effectiveness with HIT Knowledge LinksReminders Reference information links to clinical practice guidelines Can increase use of best practices Prompts and flags Can remind provider of recommended interventions MonitoringStructured Notes Quality metric reporting Can identify gaps in practice Standardized observations Can enhance assessment and diagnosis Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 9

10 Enhancing Patient Centeredness with HIT Knowledge accessPatient portal Patient-friendly web sites Can provide medical information and access to support groups Patient access and manage own health record Can enable self- management Tailor to Patient NeedsDisease management Clinical decision support Can tailor information according to patient characteristics and condition Customized health education and disease management messaging Can enable self- management Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 10

11 Enhancing Timeliness with HIT TelemedicineClinicians Reminders Internet-based access Can provide immediate access to medical information Task list schedules Can remind nurses when treatments are due Time-sensitive PromptsPatient Reminders Timed draw alerts Can remind nurse when to draw blood based on a medication intervention Appointment scheduling Can remind patients when they need to return for follow-up visits Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 11

12 Enhancing Efficiency with HIT Wireless mobile technology Character expansion Vital Sign Capture Can eliminate need to write or type vital signs Ability to translate a few characters into phrases, sentences or paragraphs Can decrease typing time System integrationClinical decision support Pull forward historical information Can reduce data collection time Prompt for duplicate labs Can reduce redundant laboratory testing Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 12

13 Enhancing Equity with HIT Data captureMulti-Modal functionality Monitoring by population characteristics Can uncover health care disparities Various ways for patients to get health information Can decrease health care disparity Tailor to Patient Needs Decision support Competency-based patient education Can tailor information to educational background and development status Drug cost information Can assist providers in selecting alternatives for low income patients Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 13

14 Unintended Consequences of HIT Work-arounds and artifacts can lead to unintended consequences. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 14 Image: MS Clipart

15 Work-arounds DefinedExamples Alternative processes that help workers avoid demands placed on them that they perceive to be unrealistic or harmful Unanticipated behaviors directly or indirectly caused by the EHR when the system impedes one’s work Nurses taking verbal orders rather than prescribers entering the order into POE due to workflow timing of event Significant events located in multiple locations in the EHR due to lack of standardization of data entry screens Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 15

16 Artifacts DefinedExamples Man-made tools that aid or enhance the worker’s thinking abilities Developed to meet the demands of an activity Bedside references Patient locator boards Report sheets Documenting on paper then transcribing into electronic record Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 16

17 HIT & Workarounds Dr. Foxwood creates a new order each time he wants to re-order a medicine. The nurse enters a verbal order to discontinue the previous order, so that the previous drug doesn’t appear on medication administration list. Dr. Foxwood fails to co-sign the discontinuation order because he sees this as an administrative task. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 17

18 1) Patient Armbands 2) Children’s Hospital – Pittsburgh, PA. 3) Cedar’s Sinai Medical Center Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 18 HIT & Workarounds Images: http://healthit.ahrq.gov, www.nia.nih.gov, http://www.systematic.com

19 When a bar-coding medication system interfered with their workflow, nurses developed workarounds, such as removing the armband from the patient and attaching it to the bed because the barcode reader failed to interpret bar codes when the bracelet curved tightly around a small arm. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 19 Bar-Code Medication Workarounds Image: www.systematic.com

20 CPOE changed the workflow, resulting in increased pediatric deaths. Order entry required up to10 clicks & took as long as 2 minutes When the team changed its workflow to accommodate CPOE, face- to-face contact among team members diminished. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 20 CPOE Workarounds Image: http://healthit.ahrq.gov

21 A $34 million system was shut down after 3 months due to the medical staff’s rebellion. Reasons for the rebellion included the additional time it took to complete the structured information forms, failure of the system to recognize misspellings, and intrusive and interruptive automated alerts the clinicians’ workflow. Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 21 HIT & Workflow Barriers Image: www.nia.nih.gov

22 Summary for Unit 1c: When designed well and used as intended, HIT can –Improve safety, effectiveness, efficiency, equity, timeliness, and patient-centeredness of care –Work to accomplish the best care for the whole population at the lowest cost When designed poorly and subject to work- arounds, HIT can result in unintended adverse consequences Component 12/Unit 1 Health IT Workforce Curriculum Version 2.0/Spring 2011 22

Download ppt "Unit 1c: Relationship of QI and HIT Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department of Health."

Similar presentations

INTRO TO MEDICAL INFORMATICS: TUTORIAL

INTRO TO MEDICAL INFORMATICS: TUTORIAL
What IMPACT Means to Physicians November 2014 Physician Champion: William Bradshaw, MD, FACS.

What IMPACT Means to Physicians November 2014 Physician Champion: William Bradshaw, MD, FACS.
Decision Support for Quality Improvement

Decision Support for Quality Improvement
Computerization of the practice Grzegorz Margas, M.D., Ph.D. Department of Family Medicine Jagiellonian University Medical College.

Computerization of the practice Grzegorz Margas, M.D., Ph.D. Department of Family Medicine Jagiellonian University Medical College.
Unit 6c: Alerts and Clinical Reminders Decision Support for Quality Improvement This material was developed by Johns Hopkins University, funded by the.

Unit 6c: Alerts and Clinical Reminders Decision Support for Quality Improvement This material was developed by Johns Hopkins University, funded by the.
Informatics And The New Healthcare System Information Technology Will Provide the Platform for Quality Improvement in Healthcare for the 21 st Century.

Informatics And The New Healthcare System Information Technology Will Provide the Platform for Quality Improvement in Healthcare for the 21 st Century.
Chapter 2 Electronic Health Records

Chapter 2 Electronic Health Records
Medical Informatics Medical informatics is the application of computer technology to all fields of medicine - medical care, medical teaching, and medical.

Medical Informatics "Medical informatics is the application of computer technology to all fields of medicine - medical care, medical teaching, and medical.
Unit 6b: Clinical Decision Support Systems that Help Improve Quality Decision Support for Quality Improvement This material was developed by Johns Hopkins.

Unit 6b: Clinical Decision Support Systems that Help Improve Quality Decision Support for Quality Improvement This material was developed by Johns Hopkins.
Unit 6.2: Clinical Decision Support Systems that Help Improve Quality Decision Support for Quality Improvement Component 12/Unit 6.21Health IT Workforce.

Unit 6.2: Clinical Decision Support Systems that Help Improve Quality Decision Support for Quality Improvement Component 12/Unit 6.21Health IT Workforce.
Current and Emerging Use of Clinical Information Systems

Current and Emerging Use of Clinical Information Systems
Decision Support for Quality Improvement

Decision Support for Quality Improvement
Component 10 – Fundamentals of Workflow Process Analysis and Redesign

Component 10 – Fundamentals of Workflow Process Analysis and Redesign
Quality Improvement HIT Design to Support Teamwork and Communication Lecture a This material (Comp12_Unit7a) was developed by Johns Hopkins University,

Quality Improvement HIT Design to Support Teamwork and Communication Lecture a This material (Comp12_Unit7a) was developed by Johns Hopkins University,
Component 10 – Fundamentals of Workflow Process Analysis and Redesign Unit 10 – Process Change Implementation and Evaluation This material was developed.

Component 10 – Fundamentals of Workflow Process Analysis and Redesign Unit 10 – Process Change Implementation and Evaluation This material was developed.
Unit 11C: Data Quality Attributes Data Quality Improvement This material was developed by Johns Hopkins University, funded by the Department of Health.

Unit 11C: Data Quality Attributes Data Quality Improvement This material was developed by Johns Hopkins University, funded by the Department of Health.
 Definitions  Goals of automation in pharmacy  Advantages/disadvantages of automation  Application of automation to the medication use process  Clinical.

 Definitions  Goals of automation in pharmacy  Advantages/disadvantages of automation  Application of automation to the medication use process  Clinical.
Unit 1a: Health Care Quality and HIT Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department of Health.

Unit 1a: Health Care Quality and HIT Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department of Health.
Copyright © 2009 by The McGraw-Hill Companies, Inc. All Rights Reserved. McGraw-Hill Chapter 4 Electronic Health Records in the Hospital Electronic Health.

Copyright © 2009 by The McGraw-Hill Companies, Inc. All Rights Reserved. McGraw-Hill Chapter 4 Electronic Health Records in the Hospital Electronic Health.
Introduction to Healthcare and Public Health in the US The Evolution and Reform of Healthcare in the US Lecture d This material (Comp1_Unit9d) was developed.

Introduction to Healthcare and Public Health in the US The Evolution and Reform of Healthcare in the US Lecture d This material (Comp1_Unit9d) was developed.

Similar presentations

Ads by Google