Using electronic health records to improve treatment quality and safety

KPMG Center for Healthcare Regulatory Insight

Dr. Farzad Mostashari spoke at KPMG's Center for Healthcare Regulatory Insight on Feb. 15 about using electronic health records to improve treatment quality and safety.


Ok, so how can technology help us address quality of healthcare. The rate with which people have their blood pressure control. Well, ok this was our thinking. Right, the electronic health records should automatically be collecting, as a part of the routine delivery of care, people's blood pressures. In a way that can be calculated and their medications, whether they're on athiazide. And with there diagnosis, whether they have hypertension diagnosed. And when a provider is giving that care to the patient, as they're delivering the care, is gathering all the information seamlessly as a part of delivering care. And then getting the doc a little bit of a reminder, "Hey by the way, person had high blood pressure and like ninety percent of people with high blood pressure and walk into the doctor's office they walk out again with zero change in their therapy". But we proved in New York, that if you put a little bit of an alert right there, a little decision support in that workflow, you can improve the rate with which people actually noticed. That many people suggestions while they're on this medication, but how about we consider this medication or you know what they're not taking their medication. Like thirty percent of people get a prescription never fill it. That was the idea, but to do that you need those building blocks in place. You need to know what the patient's blood pressure is, what meds they're on and what are their diagnosis. Well here you're a fifth of the way to meaningful use.

We said we want to prevent patients from dying from medical errors. Biggest source of medical errors on the outpatient side is medications again. And on the innovation side, hospital acquired conditions. So there's a whole bunch of stuff around "Safe Prescribing". Right, this was David Blumenthal's aha moment. Right, he was prescribing medication to patients that popped up and said hey they're allergic. So you gotta collect the allergies and the medications. You got actually order the medications through the system so that you're there you can see that respondent has got to be closed loop. Then you don't have a you know a pharmacist typing in 10 times the dose into their pharmacy dispensing system. We have that now, and we know that hospitals that implemented those five, now you're halfway to meaningful use, right yet it is possible to implement those five measures for Meaningful Use had thirty percent lower rate of adverse medication events. This we have reduced hospital acquired conditions. But what was the problem? That some i'm thinking you this thing and you're like well but I've heard there's a lot of problems. What's the problem? One problem that we/I think about this is we had these incredible leaders but their regulatory leaders.

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