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11/23/2010
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Health Execs Laud EHRs For Boosting Care

Government Accountability Office report finds that e-health records support disease management by improving data sharing and communication.

Health IT Boosts Patient Care, Safety
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Integrated healthcare delivery organizations say electronic health records (EHRs) support their patient care strategies by increasing the availability of individual patient and patient population data and by improving communication among providers.

These findings are from a U.S. Government Accountability Office (GAO) report, Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges.

The GAO examined 15 private and public integrated delivery systems (IDSs) that are clinically aligned across primary, specialty, and acute care. These healthcare organizations vary in their degree of integration, specific organizational features, and payer mix (such as the extent to which they serve Medicare and Medicaid beneficiaries and the uninsured).

The report offers a glimpse into how chief medical officers and other systems officials are using digitized medical records, as well as their evaluation of the impact of EHRs on patient care, including care coordination, disease management, and use of care protocols.

All 15 IDSs reported having, to some extent, implemented EHRs. Officials at some IDSs said using EHRs helps their care coordination strategies because they make patient information more readily available and thereby improve communication among providers, staff, and patients.

One example is Denver Health, a public hospital in Colorado. Denver Health uses its EHR system to support care coordination by scanning within 24 hours of patient contact physician notes from patient encounters and making clinical information, such as previous laboratory tests, available to all providers. An official from the Mayo Clinic, Rochester Region, based in Rochester, Minn. told GAO that the information in its EHR system helps avoid overutilization and duplication of services.

Similarly, Marshfield Clinic, a private healthcare facility, makes EHRs available at its locations in central, western, and northern Wisconsin. The EHR system gives providers access to clinical information, digital radiology images, and capabilities such as e-prescribing. The report said that at Marshfield Clinic, each patient's EHR contains a dashboard to highlight needed services and to facilitate communication and collaboration among providers. Marshfield's EHR also generates a list of high-risk patients in need of interventions so that physicians and other staff can follow up with those patients.

IDS officials said EHRs facilitate disease management by making patient-level and population-level data available to providers, which allows providers and IDSs to adjust approaches to treatment based on individual patient and population-wide progress.

Because the EHR provides real-time clinical information, providers are able to see test results immediately upon completion, which might not be possible without an EHR. Having real-time information allows providers to initiate appropriate treatment or follow-up, and to anticipate and mitigate potential problems, more easily and much earlier.

Respondents reported that using EHRs with e-prescribing and computerized physician order entry (CPOE) capabilities reduces errors and lowers costs. And some said that their EHRs facilitate the use of care protocols and clinical practice guidelines by prompting providers to use them and tracking their use.

However, respondents said implementing an EHR system is financially and operationally challenging. They also cited challenges related to sharing the clinical information in patients' EHRs with providers outside of their systems. Some IDS officials said that, while they make their EHRs available to outside providers who also treat their patients, these outside providers can read the EHRs, but cannot directly enter clinical information to update a patient's medical notes.

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