BackgroundBeginning with the Administration of George W. Bush, and continuing with the Administration of Barack Obama, there has been consistent federal leadership in enabling the widespread adoption and meaningful use of health IT to transform care in our nation. The goal of both Administrations has been to improve both patient care outcomes, and the cost-efficiency of that care.
This leadership, backed by landmark 2009 legislation providing critical funding, has led us to the crossroads of change. Caregivers will be able to access information securely when and where needed. Secure portals will enable patients to increasingly manage their healthcare. No longer operating in silos, clinicians will interactively use health IT to better manage costs and optimally care for patients based on relevant and current clinical information.
Recent DevelopmentsOver the past fourteen months, the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT have issued regulations to implement the HITECH portion of the Recovery Act. And, the Affordable Care Act has been signed into law, which contains critical next steps in better managing costs and improving quality using health IT. Legislation, which is unlikely to be signed into law under the current Administration, has been introduced which would repeal all unobligated funding for EHR incentives. And, efforts are underway to repeal all provisions in ACA. The result is an atmosphere of uncertainty for providers and the patients they care for.
HIMSS Statement of PositionProviders must consider the pros and cons associated with the acquisition and implementation of health IT. For example, early adopters face greater challenges; trailblazing is simply more difficult than following an established path. On the other hand, holding off on acquiring and implementing health IT can delay a provider’s ability to improve the quality of the care provided to patients, and to effectively control the costs of that care. Then, there are the political questions clouding the future stability of federal financial incentives for health IT.
Over the course of its 50-year history, HIMSS has dedicated itself to the cause of improved quality, safety, access, and cost-effective healthcare through the optimal use of IT. Each year, HIMSS publishes over 200 new tools, publications, and resources to equip stakeholders for transforming healthcare through IT. By sharing real-world examples of how IT is effectively deployed to improve quality and manage costs, we enable stakeholders to make informed decisions regarding acquisitions, implementation, and optimization. In the current reality of the EHR Incentive Program, created under the HITECH section of the Recovery Act, HIMSS has tirelessly worked to deliver impactful materials and education such that decision-makers make smart decisions about health IT.
In the end, you must make the decision that is right for your healthcare organization and your patients. We believe the time to act is now – the nation needs better quality care and greater cost-efficiencies. Health IT is a powerful tool to achieve this transformation. Let us not waste this opportunity—for our patients and for our future.
Davies Organizational Awards•Sentara Healthcare – Davies 2010 - ROI – $9.4 M in length of stay savings due to streamlined care processes Pt Safety & Quality - CPOE reduced medication order entry to administration time from 59 minutes to 4 minutes. •Nemours – Davies 2010 - Pt Safety & Quality: A closed-loop bar-coding system that has resulted in a 99.5% medication error-free rate. Rate of complete documented outpatient medication reconciliation improved from 30% of encounters to near 90%. ROI: Electronic systems assure charges for items used during surgery are appropriately captured ; w/o increase in volume or price for items used, OR total charges (remain) increased 30%, 1M+/quarter. •MultiCare – Davies 2009 - ROI: An initial net benefit in excess of $42.6 M since June 2007 with ROI projections to break even in 2012.Patient Safety & Quality: 45% reduction from the time a routine med is ordered to the time it is verified by Pharmacy.•Allina Hospitals & Clinics – Davies 2008 ROI: Revenue cycle improvements”↑”: Accounts receivable days: 21%↑, Claims denied: 27%↑, Number of wrong insurance claims:50%↑, Data Quality:20%↑,Eligibility determination: 25%↑, Patient Identification: 25%↑. Pt Safety & Quality Outcomes: Panel of 17,000 diabetic patients: 130 fewer strokes, 400 fewer heart attacks, 200 fewer deaths, 300 fewer cases diabetic eye disease.
Davies Ambulatory & CHO Awards•Cardiology Consultants of Philadelphia – Davies Ambulatory ’08 - ROI: CCP received more than $300,000 for participation in PQRI in ‘08 (received in ‘09). Pt Safety: Identified all patients implanted with Medtronic's Fidelis defibrillator lead, 10 min after recall notification; identified 100+pts beyond those identified in the records of the device manufacturer within 10 min and auto-generated letters.•Open Door Family Medical Center – Davies CHO ’10 - ROI: Increased clinical performance incentives ($381,161 YTD), decreased medical records personnel ($216,644 YTD), and decreased printing costs ($81,943 YTD). Pt Safety & Quality: EHR enables 100% of a targeted population to be captured (not just sample). Diabetic and Hypertensive patients, identified as 15% adult population, utilize 27% visit volume. A1c below 7 increased, 35% to 44%. BP control improved, 38% to 62%.•Columbia Basin Health Association – Davies CHO ’08 - ROI: Productivity. Average Total Encounters (‘98-‘07) increased at a higher rate than increases in staff: Encounters/physician ↑ 21%, Encounters/ mid-level provider ↑ 25%; ranked above 95% nationally in total medical team productivity as reported in the Bureau of Primary Health Care Uniform Data System (UDS). Pt Safety & Quality: 98% of all children consistently receive all recommended immunizations.•ARcare (formerly White River Rural Health) – Davies CHO ’08 - ROI: Average claim payment turnaround days decreased from 287 to 45. Pt Safety & Quality: improved blood pressure measurement from < 40% to 100% compliance. •Virginia Women’s Center– Davies Ambulatory ’09 – ROI: Volume of patient throughput was increased. Pre EHR, average number of annual patient visits/provider 5,314. Post implementation, 11% increase to 5,629. Patient Safety & Quality: Recall on Group B Streptococcal culture results; same day, notified affected patients and on-call physicians, established a mechanism to provide repeat cultures.•Miramont Family Medicine– Davies Ambulatory ’10 – ROI: reduced transcription costs by 55% over a three year period. Patient Safety & Quality: Diabetic patients with documented A1C’s has gone from 42% to 91.4%
Stories of Success – Case Studies•Princeton Baptist Medical Center – Stories of Success ’11 - Pt Safety & Quality: Electronic hand hygiene surveillance and feedback monitoring device (via RFID) led to a 22% decrease in electronic infection markers, a decrease of 159 patient days. ROI: Reduced hospital net losses of over $133,386.•Veterans Healthcare System of the Ozarks – Stories of Success ’11 - Pt Safety & Quality: Safety action documentation fields embedded within the notes of electronic record, improved communication. No major fall injury complication reported inpatient for 21 months, outpatient for 16 months. ROI: Potential cost savings, $34K/ patient as per information presented in the National Center for Patient Safety’s electronic Falls Toolkit. •Eastern Maine Medical Center - Stories of Success ’10 & Davies ORG ’08 - ROI: 25%+ reduction blood acquisition costs (reduction of over $517,000 from a total budget of just over $2,000,000). Patient safety: CPOE requires the ordering physician document the clinical indication for transfusion at the time a transfusion order is entered, facilitating real time consideration of transfusion guidelines.•NorthShore University Health System - Stories of Success ’10 & Davies ORG ’02 - Pt Safety: Via EHR: 10% reduction patient days with urinary catheter, 20% decrease Catheter Associated Urinary Tract Infections. ROI: Annual savings $200,000 in avoided charges.
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