Report: Hospitals must change priorities during EHR implementation
Converting physician's notes into electronic documentation earlier in the typical implementation cycle for an inpatient EHR would give hospitals a more complete information base for quality management, according to a white paper from Computer Sciences Corp. (CSC), a Falls Church, Va.-based consulting firm.
If hospitals changed their priorities when implementing EHRs, they would be better equipped to provide adequate data for core measures that many payors demand, as part of national quality performance measures for pay-for-performance programs and other projects required by the Centers for Medicare & Medicaid Services (CMS), payors and some states.
The report authors looked at the medical and surgical core measures, such as acute myocardial infarction, heart failure, pneumonia and surgical care, to examine the data elements. The considered the following questions:
• What types of information are needed for core measures?
• How many data elements can the typical hospital core systems provide?
• What types of clinician documentation are major sources of the information needed for core measures?
• What does the information say about quality reporting and concurrent quality management?
The authors observed that the "typical sequence of implementing the inpatient EHR usually places electronic problem lists and physician documentation at the end of the journey, although the medical and surgical core measures rely heavily on information that can be provided by these sources."
The report also noted that during each step of the EHR implementation, hospitals need to build in core-measure-related clinical decision support and maximize the ability to collect the information needed for quality management.
"Because quality metrics such as core measures are so complicated, we recommend that quality nurses participate during both the planning and detailed design phases of an EHR implementation," the authors wrote.
If hospitals changed their priorities when implementing EHRs, they would be better equipped to provide adequate data for core measures that many payors demand, as part of national quality performance measures for pay-for-performance programs and other projects required by the Centers for Medicare & Medicaid Services (CMS), payors and some states.
The report authors looked at the medical and surgical core measures, such as acute myocardial infarction, heart failure, pneumonia and surgical care, to examine the data elements. The considered the following questions:
• What types of information are needed for core measures?
• How many data elements can the typical hospital core systems provide?
• What types of clinician documentation are major sources of the information needed for core measures?
• What does the information say about quality reporting and concurrent quality management?
The authors observed that the "typical sequence of implementing the inpatient EHR usually places electronic problem lists and physician documentation at the end of the journey, although the medical and surgical core measures rely heavily on information that can be provided by these sources."
The report also noted that during each step of the EHR implementation, hospitals need to build in core-measure-related clinical decision support and maximize the ability to collect the information needed for quality management.
"Because quality metrics such as core measures are so complicated, we recommend that quality nurses participate during both the planning and detailed design phases of an EHR implementation," the authors wrote.