Health Information Technology and Continuous Quality Improvement

America’s health information technology (HIT) network should transform health care into a learning system that has the capacity to instantaneously diffuse new medical information and innovations in technology or delivery models throughout the health care system, and make selfcorrections (such as identification and correction of systemic sources of medical errors) to drive continuous quality improvement.

Cost reduction and quality improvement associated with effective care coordination requires linkage of health care providers and patients through a nationwide HIT network. Minimally, this will require development and application of standards that allow interoperability of medical records among providers. In addition, the national HIT network should:

    • Provide decision support to health providers based on evidence-based guidelines

    • Provide for e-prescribing of medications and tracking of patient compliance

    • Provide provider and patient reminders for recommended care

    • Reduce administrative costs associated with patient billing and adjudication of insurance claims

    • Streamline paperwork requirements associated with provider credentialing

    • Support telemetry (or remote monitoring) of care, in homes and in remote locales

    • Assure privacy and security of patient medical records

To advance these objectives, legislation addressing Health Information Technology should:

  1. Accelerate development of standards and full implementation of interoperable medical record keeping throughout the health care system, with security protections to protect against inappropriate access or use.

  2. Fund the development of standards for automated, electronic hospital medical error internal data collection that will identify and enable self-correction of systemic sources of medical errors. Adoption by hospitals should be required in an expedited time period and assistance for adoption should be provided where necessary. Hospital medical error statistics should be publicly reported.

  3. Provide payment incentives for the use of decision support tools that provide physicians with reminders and guidance based on consensus-based quality measures. The Certification Commission for Healthcare Information Technology (CCHIT) will release initial certification standards for Advanced Clinical Decision Support in June 2010. A payment incentive program should be established by the release date in an effort to encourage providers to begin using the tools immediately.

  4. Provide payment incentives for use of HIT in all federally-funded or supported health programs.The incentives should be modeled on Medicare, which incentivizes providers to use e-prescribing tools to prescribe medication and track patient compliance.

  5. Move toward development of a common 100% electronic insurance claims form and bill coding system.

  6. Incentivize insurers to resolve claims disputes through electronic methods.

  7. Provide subsidies to state boards responsible for credentialing medical providers to encourage the use of health information technology rather than paper-based applications.

  8. Provide federal subsidies for adoption of telemetry (or remote monitoring). Subsidies should be provided for distant care of patients in rural areas where there is scarcity of credentialed medical professionals as well as for adoption of telemetry in homes and where use can reduce the need for office visits and improve outcomes.

America’s health information technology (HIT) network should transform health care into a learning system that has the capacity to instantaneously diffuse new medical information and innovations in technology or delivery models throughout the health care system, and make selfcorrections (such as identification and correction of systemic sources of medical errors) to drive continuous quality improvement.

Cost reduction and quality improvement associated with effective care coordination requires linkage of health care providers and patients through a nationwide HIT network. Minimally, this will require development and application of standards that allow interoperability of medical records among providers. In addition, the national HIT network should:

    • Provide decision support to health providers based on evidence-based guidelines

    • Provide for e-prescribing of medications and tracking of patient compliance

    • Provide provider and patient reminders for recommended care

    • Reduce administrative costs associated with patient billing and adjudication of insurance claims

    • Streamline paperwork requirements associated with provider credentialing

    • Support telemetry (or remote monitoring) of care, in homes and in remote locales

    • Assure privacy and security of patient medical records

To advance these objectives, legislation addressing Health Information Technology should:

  1. Accelerate development of standards and full implementation of interoperable medical record keeping throughout the health care system, with security protections to protect against inappropriate access or use.

  2. Fund the development of standards for automated, electronic hospital medical error internal data collection that will identify and enable self-correction of systemic sources of medical errors. Adoption by hospitals should be required in an expedited time period and assistance for adoption should be provided where necessary. Hospital medical error statistics should be publicly reported.

  3. Provide payment incentives for the use of decision support tools that provide physicians with reminders and guidance based on consensus-based quality measures. The Certification Commission for Healthcare Information Technology (CCHIT) will release initial certification standards for Advanced Clinical Decision Support in June 2010. A payment incentive program should be established by the release date in an effort to encourage providers to begin using the tools immediately.

  4. Provide payment incentives for use of HIT in all federally-funded or supported health programs.The incentives should be modeled on Medicare, which incentivizes providers to use e-prescribing tools to prescribe medication and track patient compliance.

  5. Move toward development of a common 100% electronic insurance claims form and bill coding system.

  6. Incentivize insurers to resolve claims disputes through electronic methods.

  7. Provide subsidies to state boards responsible for credentialing medical providers to encourage the use of health information technology rather than paper-based applications.

  8. Provide federal subsidies for adoption of telemetry (or remote monitoring). Subsidies should be provided for distant care of patients in rural areas where there is scarcity of credentialed medical professionals as well as for adoption of telemetry in homes and where use can reduce the need for office visits and improve outcomes.

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Health Information Technology

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