Keeping Focused on Clinical Care

Every week seems to bring its share of crises. This morning, headlines continue to feature the possibility of a Greek debt default as the country does not have sufficient funds to continue functioning beyond October. Markets are see-sawing every week by wide margins and no matter how good a visionary one is, there are too many variables to take into account, making it impossible to predict the future.

What differs at a high level between the financial markets and healthcare is the strong dependence on performance measurement when analyzing financial data. Healthcare is far behind in terms of having accurate and trustworthy data available on demand to guide either clinical decisions or to manage populations of patients with chronic disease or other conditions.

Although EHRs, information exchanges, and information technology provide a critical foundation in order to collect and present data, it is easy to lose sight of the tools at your fingertips when there are urgent clinical problems to be managed. Beyond learning to use the EHR more effectively, there is a another aspect to EHRs that can be very helpful — namely the ability to generate performance reports for your patients and for your clinic.

The Meaningful Use measures require outcomes-based performance and reporting. However, as your practice implements EHR systems that are able to collect and report clinical data, you have at your fingertips the ability keep focused on clinical care by creating your own performance reports.

With a Meaningful Use certified EHR, you should be able to set up reports at either the personal or practice level. This is highly dependent on whether your practice has developed a level of comfort with the system and the concept of performance reporting.

For example, if your practice has a high proportion of patients with a specific condition that you would like to monitor, e.g. Type II Diabetes, establish some internal metrics and reports that are produced and circulated among all clinicians on a cyclical basis. An example could be HbA1C measurements for all Diabetic patients across all clinical providers. Ensure that everyone in the practice is comfortable seeing their performance measured and reported against colleagues. This can be quite scary initially; however, once the initial shock has worn off it is very informative and allows you to set internal and personal goals that are measurable.

Once the reports are set up and automated, it does not take long to review your progress and see where you would like to focus. In a busy practice, if you have 1% of capacity that you are able to dedicate to improving care in a specific area, having a weekly or monthly report will keep your eye on the ball and will allow you to keep focused on a specific aspect of clinical care in a meaningful way. Once you are comfortable with your performance and that of your clinic, start adding additional measures that are appropriate for your practice.

While the Meaningful Use measures right now appear to be focused on qualifying for incentives, what you really have is an analytical war chest at your disposal to help you modify your practice and the way you deliver care… permanently!

If you have set up internal performance measures for yourself or your practice, please share your experiences.

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