Improving the Quality of Chronic Care
Why Clinical Information
Systems (CIS) Beat Electronic
Medical Records (EMR) Technologies at Improving Care,
Raising Provider Productivity, and Reducing Costs
Interest in Electronic Medical Records (EMR) technology has surged in recent years, fueled by a raft of new health care industry regulations and generous grants from Government and private sources. For many health care organizations, EMRs have become something of a panacea, offering the potential to lower costs and improve care quality for a growing number of chronically ill patients. But can EMRs deliver on this promise? Studies show that providers who expect to see quality improvements from deploying an EMR will be disappointed.
In a 2007 study published in the Archives of Internal Medicine, Jeffrey Linder, et al, found that the use of EMR technology made no difference in performance outcomes, measured using 17 ambulatory quality measures [1]. Although the technology showed an immediate and direct impact on safety related concerns in an inpatient environment, EMRs were not associated with health care quality improvements in an outpatient setting.
So, how should a health care organization go about improving the quality of chronic care, raising provider productivity, and lowering costs?
A 2002 study of the CareSouth Carolina community health care organization documented an average 70 percent reduction in hospitalizations, 68 percent reduction in hospitalization costs, and close to 80 percent reduction in total costs per patient per year when compared to other community providers [2]. CareSouth Carolina achieved these astounding improvements by using the Chronic Care Model (CCM), developed by Dr. Ed Wagner, et al [3], and the PECSYS® Clinical Information System (CIS) software from The Aristos Group.
The Patient Electronic Care System (PECSYS) CIS software was developed by The Aristos Group for the U.S. Department of Health and Human Services Bureau of Primary Health Care (BPHC), specifically for use with the Wagner CCM framework. Design of the PECSYS system was guided by input from a national faculty of distinguished physicians and statisticians and a clinical advisory group representing health care providers, administrators, and support personnel from health care organizations participating in the BPHC Health Disparities Collaboratives. PECSYS integrates evidence-based guidelines and known best practices to give health care providers a dynamic, flexible, and powerful tool for raising the level of patient care. The technology is implemented in a fraction of the time taken to deploy an EMR and delivers immediate quality improvements as both a stand-alone system or used alongside an EMR solution. Unlike EMR software, which is primarily designed to aid medical documentation, the PECSYS CIS solution actively improves patient care.
_____________________________
1 Linder, Jeffrey A., Bates, David W., Middleton, Blackford, Stafford, Randall S., “Electronic Health Record Use and the Quality of Ambulatory Care in the United States.” Archives of Internal Medicine, Volume 167, Number 13. July 9, 2007.
2 Piturro, Marlene, “The Chronic Care Model—A Quality Innovation”, American Medical Directors Association, Volume 4, Number 9. September 2003. http://www.amda.com/publications/caring/september2003/chronic_care.cfm.
3 Wagner, E. H., “The Chronic Care Model: Improving Chronic Illness Care.” http://www.improvingchroniccare.org/index.php?p=The_Chronic_Care_Model&s=2.