The drive to modernize health care through the adoption of electronic health records (EHR) and the exchange of health information has been a challenging one. As we approach the end of 2013, it is impressive to see the progress that we have made so far. Yet in many ways, the work has just begun.
In 2010, Altarum Institute’s Michigan Center for Effective Information Technology Adoption (M-CEITA) was established to help priority primary care physicians select, adopt, and implement new EHRs. M-CEITA has specifically focused on providers in settings such as small independent practices and underserved communities, as these providers are typically less likely to have information technology resources to support implementing such a system. To date, M-CEITA has exceeded its goal, reaching more than 4,000 providers with health IT integration, advancing the rate of physician adoption from 42% when the program began to more than 66% today. This milestone is significant because adoption and meaningful use of an EHR translates into clinical quality improvements for practices and lays a foundation for better care coordination throughout the state.
The Kresge Foundation contributed to this success through a generous contribution of $1 million at the start of the project. Kresge’s support supplemented a federally funded grant from the Office of the National Coordinator for Health Information Technology to make our work possible.
M-CEITA’s technical assistance in EHR technology adoption has been especially important to providers treating underserved populations in rural practices and critical access hospitals. For example, Sheridan Community Hospital, a Michigan-based critical access hospital, reached out to M-CEITA for assistance with implementation and guidance in using their new technology to improve quality of care. Kevin Perdue, Client Services Manager at Altarum, described the important operational improvements made through the program: “Providers working within Sheridan’s hospital and clinics are now able to send and receive orders, results, and other clinical information electronically. Leveraging their EHR has saved time, improved care coordination, and greatly enhanced their understanding of their patient population’s health through advanced reporting analytics.”
Working with funding through the state of Michigan, M-CEITA continues to assist providers that serve the Medicaid population. Focusing on these providers is essential, because Michigan Medicaid provides health care coverage to more than 2 million individuals, and often the physicians do not have the resources to invest in technology. M-CEITA is working to ensure that Medicaid and other underserved patients will have better coordinated and documented care. What does this mean to Michigan? More comprehensive documentation of patient’s health information and treatment, helping providers avoid mistakes and waste while improving the delivery of care and, ultimately, health outcomes. Additionally, the ability to capture this electronic clinical information in public health registries vastly improves our ability to manage population health in real time. All of this leads to better care for patients who need it most.
Although M-CEITA has achieved its initial goal of assisting with the implementation of EHR systems, the real value of the program lies in leveraging this new information to redesign care delivery. The program’s team sees many opportunities to positively affect the long-term health of Michiganders through practice redesign, quality improvement, and patient engagement. “Information is a key asset to drive continuous improvement in our health care system. We now have the foundation to capture health information electronically. The true transformation will come from leveraging the insights these data provide to inform patient outreach, redesign processes, and better manage care,” says Bobbi Coluni, Deputy Director of Altarum’s Information and Technology Strategies Group.
To that end, M-CEITA is assisting providers with tools to apply best practices. The following initiatives are snapshots of how a redesigned process can change the patient experience and affect community health outcomes:
- Practice redesign focused on quality. With new technology, practices need to rethink their operational processes. Using Lean Six Sigma principles, M-CEITA helps providers capture information, reduce risk, and improve clinical quality through a practice process redesign. The new process often saves the practice time and money while increasing quality. It allows for patient data to be quantified and used as a benchmark to improve community health.
- Engaging patients. Recent studies show that engaged patients are less costly and have better health outcomes. Additionally, payment reform has raised the bar on getting providers focused on patient engagement due to published pricing and patient satisfaction scores. M-CEITA assists providers with utilizing best practices and EHR tools to engage their patients to be true partners in their health care decisions. These best practices range from providing patients with their health information to shared decision-making for personalized treatments to providing self-managed medication tools.
- Facilitating population health management. Providers are in the midst of transforming from a reactive model, where they manage the patient in the exam room; to a proactive model of population health management, where they look at the whole picture as it relates to health within the community. This transition requires new information and approaches. M-CEITA works with providers to leverage their EHRs in monitoring quality metrics for their whole population of patients. For example, implementing clinical decision support tools helps providers continuously improve the health of their population.
As M-CEITA grows into its next phase, the goal remains bringing better health care to Michigan and improving patient outcomes, particularly for the most needy and vulnerable within the community.