The key factor in improving the quality of health care is better coordination of care between patients and providers.
This is the one theme that resonated strongly over all others when I attended an executive conference my company held to get feedback from community hospital executives across the country. All are working extremely hard to ensure the highest quality of care for their patients while also looking for ways to improve that care.
As one executive put it, we “need to get ‘ologists’ talking together, build the infrastructure and use mobile tools so that they can collaborate.” Doing so will require achieving success on four objectives:
1.) Create a robust data warehouse that can efficiently and accurately gather and digitize patient information.
2.) Share that data with all stakeholders in accordance with HIPPA and other pertinent policies and regulations.
3.) Ensure the data is mobile and accessible wherever and whenever it’s needed.
4.) Enable patients to “take the data home,” and empower them with the ability to manage their own health care.
The persistent problem is that we as an industry are still talking about this issue in academic terms. “Mainstream” EHR and communications platforms remain too costly for most. Even if a hospital has a budget for such a system, the required implementation time prohibits most organizations from realizing an adequate return on their investment within an appropriate time frame.
The proprietary nature of such platforms means specialized IT environments must be created by well-trained — and costly — vendors and systems integrators that will, by design, force health care providers to retool practices, policies and procedures to conform to the platform. It is at this point that most organizations cry “uncle.”
But there’s too much at stake to quit. What’s more, a solution is already in use in the form of open source technology developed by the U.S. Department of Veterans Affairs.
Known as VistA, this enterprisewide clinical information management solution has been characterized by the Institute of Medicine of the National Academy of Sciences as one of the best health IT systems available. It is the most widely used EHR in the world.
VistA comprises more than 100 software modules, including computerized provider order entry, bar code medication administration, clinical documentation, pharmacy, laboratory and radiology. And because it was developed by the federal government, the system is available at virtually no cost to hospitals through the Freedom of Information Act.
A commercial version of this program is also in use and showing measurable results. Since implementing this commercial system and achieving near-paperless status, Midland Memorial Hospital — a 320-bed, HIMMS Analytics Stage 6 health care system in west Texas — has improved access to patient information, which has enabled clinicians and staff to achieve better clinical outcomes such as: fewer patient deaths; an 88 percent reduction in infection rates; fewer hospital-acquired pressure ulcers (bed sores); a 77 percent increase in compliance with ventilator care support, preventing hospital-acquired pneumonia; reduction in sepsis related to central venous access, reducing length of stay and deaths.
As technologists and health care providers, we have an obligation and opportunity to make the difference in the quality of medical services provided. The solution to improving care exists and the proof is well documented, which makes better health care more a matter of execution than deliberation. After recently hearing numerous positive, hopeful comments from those working on the frontlines of health care, I’m more excited about what’s possible than I’ve ever been.
Michael J. Doyle is chairman of Medsphere, developer of OpenVista, a portfolio of clinical support products and professional services that leverages an electronic health record system created by the Department of Veterans Affairs. He can be reached at firstname.lastname@example.org.