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Sunday, 06 January 2013 23:55

E-notification system aims to improve health care efficiency

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Kramer Kramer
GRAND RAPIDS — A pilot project between Spectrum Health and the regional health information exchange Michigan Health Connect looks to cut costly hospital readmission rates.

Under the pilot, Michigan Health Connect will electronically notify care managers and patients’ personal physicians when they are admitted to or discharged from a Spectrum Health hospital. Providing them such real-time information allows care providers outside of the Spectrum system to more quickly become involved in managing treatment for a patient while they are in the hospital and their post-hospital care after they return home.

The timely notifications “help ensure that patients discharged by Spectrum Health hospitals receive the right care, at the right time and in the right place, so they can stay healthy and avoid return trips to the hospital,” said Dr. Michael Kramer, senior vice president and chief quality officer for Spectrum Health. “We’re in the business of keeping people healthy, and this solution helps us do that.”

A patient’s personal physician office quite often doesn’t get notified immediately on an admission or discharge, even if the physician office has electronic health records. The pilot seeks to change that so physicians can follow up immediately with their patients.

The pilot builds on the electronic connections that Michigan Health Connect provides care providers to easily transmit patient data and records as they receive treatment and get referred from one physician to another and move through the health care system.

“We’re trying to figure out how to do as much as we can with that data. We still have a lot to learn in how do we deliver that data to the physicians in a meaningful way,” said Doug Dietzman, executive director of Michigan Health Connect, based in Grand Rapids. “We’re trying to notify them of an event more quickly so they can act on it more quickly.”

Doctors with electronic medical records can access admission and discharge information now via a patient’s electronic health record, but “the problem is they don’t know they need to look,” Dietzman said.

In the first six weeks of the pilot, the system sent an average of 1,500 notifications weekly, he said. Michigan Health Connect plans to expand the system to non-Spectrum members in mid-January and hopes to generate data during 2013 that shows the electronic notifications make a difference in hospital readmission rates, Dietzman said.

The pilot represents just one way health care providers increasingly use information technology to support patient care and treatment decisions, a major trend that one recent study in New York concluded can lead to the promise of improved quality.

The study by the Center for Healthcare Informatics and Policy at New York Weill Cornell Medical College concluded that electronic health records enhanced patient care.

The study compared physicians using EHRs with those who still use paper records and included 466 physicians and more than 74,000 patients in ambulatory care settings in the Hudson Valley region of New York.

The study found an “association between EHR use and higher quality ambulatory care.”

Physicians using EHRs “provided significantly higher rates of recommended care than physicians using paper for four quality measures: hemoglobin A1c testing for patients with diabetes, breast cancer screening, Chlamydia screening, and colorectal cancer screening,” researchers wrote in their report on the study, one of the first to directly correlate the use of EHRs and improved quality.

As the health care industry spends billions in I.T. investments to meet federal “meaningful use” requirements established in 2009 for EHRs, Dietzman says data showing a correlation between their use and improved care can help to further adoption by clinicians.

“The goal of everything is to figure out how to provide better care for patients and make things more efficient,” Dietzman said.

In the case of the pilot project with Spectrum Health, “the ability to notify physicians within minutes of important events so they can proactively follow up and further ensure the health of their patients is critical,” Dietzman said.

The largest health information exchange in the state, the Grand Rapids-based Michigan Health Connect is used by 55 hospitals and 1,265 medical offices statewide with more than 4,000 care providers. West Michigan participants include Spectrum Health, Metro Health, Saint Mary’s Health Care in Grand Rapids, Mercy Health Partners in Muskegon, Lakeland Health System in St. Joseph and Michigan hospitals owned by Ascension Health, including Borgess Health in Kalamazoo.

In one recent survey, 69 percent of all doctors in the U.S. reported using an EHR system, although levels of functionality differed. Another survey, by the National Center for Health Statistics at the Centers for Disease Control and Prevention, pegged basic EHR adoption for office-based physicians at nearly 40 percent.

Among the benefits of EHRs are the automatic electronic alerts for doctors to screen patients with chronic conditions, a function that was the focus of the New York study. Scheduling routine wellness and prevention checks, especially for patients with chronic conditions such as diabetes, is much easier with EHRs than with paper records, especially for physicians with a heavy patient load.

“It helps us to manage a larger patient population,” said Dr. Frank Belsito, executive vice president and chief operating officer at Metro Enterprises, the physician-hospital organization for Metro Health in Grand Rapids.

“It raises the bar a little bit for me to work that much better for patients,” Belsito said. “The more and more you can change that patient-care process, that makes the care better for all of us.

Metro Health implemented fully integrated EHRs three years ago. One of the most noticeable benefits for Belsito is the ability to readily access results from patient diagnostic tests. No longer does he have to spend half of a patient’s office appointment searching for paper records or sifting through a medical chart to find, for instance, the results of a blood test to check their cholesterol level or blood glucose.

That enables him to spend more time directly interacting with patients, particularly where people need help managing a chronic medical condition such as diabetes.

“So the quality of the time I spend with the patient goes up and up,” Belsito said. “There’s opportunity to enhance what are we there to talk about and what else do we need to do from a health standpoint.”

Read 3136 times Last modified on Sunday, 06 January 2013 00:09

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