Defining the elements that constitute “quality care” is not an overly difficult task. Most healthcare experts, in fact, probably would agree that – at the broadest level – quality care means making sure the right patient receives the right care at the right time, every time.
Less simple, however, is ensuring that providers are equipped to fulfill this objective. To do so, healthcare organizations must be able to guarantee that the right clinician has the right information at the right time to make the right decisions regarding care.
While healthcare organizations have long endeavored to place critical and comprehensive patient information into caregivers’ hands precisely when it’s needed, they have often been unsuccessful. Paper documents such as test results or chart notes may not be conveniently available. When information technology systems are implemented, electronic data is often stored in silos across both acute and community care environments – making it difficult to access for caregivers using different technology systems at different locations.
What is needed to vault healthcare to the next level of quality improvement are technological solutions that (1) create a longitudinal health record and (2) deliver comprehensive information about individual patients at the point of care.
The University of Pittsburgh Medical Center (UPMC) launched such an initiative early in 2008 and is already realizing significant quality benefits. UPMC, which provides care in 20 hospitals as well as in doctors’ offices, outpatient treatment centers, imaging facilities and other settings, went live with an interoperability platform developed by dbMotion, a company whose technology so impressed UPMC that it decided to invest in the business.
Through the use of this semantic interoperability platform, the organization is creating a unified record from the disparate sources that generate patient data, no matter what format data are stored in or where they are located. The advanced nature of the technology enables users to do more than simply import and review information from disparate systems. It preserves the original meaning of the data and integrates the information for comprehensive analysis and trending, thus enhancing the provider’s diagnostic and therapeutic decision-making.
When a patient presents at a UPMC emergency department (ED), for instance, the ED physician is able to access most outpatient and inpatient records throughout the UPMC system within the physician’s own workflow – all with a minimal number of mouse clicks. He can check to see when the patient was last seen by his primary care physician, what medications have been prescribed, what his most recent lab results revealed, and whether or not the patient had been hospitalized or undergone outpatient procedures at UPMC. With this information in hand, the ED physician is better able to pinpoint the cause of current symptoms and make an informed decision about next steps.
To further drive home this point, consider a situation that recently occurred at UPMC: A patient suffering from chest pains visited a cardiologist who, with just a few clicks of his computer mouse, called up the comprehensive medical record. He was able to see that another specialist had previously evaluated this patient for thyroid disease and treated elevated cholesterol.
This information significantly affected both work-flow and the care plan. In another situation, a patient presented to an ED within the UPMC system, complaining of back pain and claiming that he had not seen another physician in months. Via the interoperability platform, the treating physician accessed the patient’s history of encounters and prescribed medications. It was discovered the patient had, in fact, been seen recently by his PCP and had been prescribed 60 Percocet tablets. Suspecting drug-seeking behavior, the ED physician confronted the patient, was able to address narcotic abuse and alert the PCP regarding ongoing rehabilitation.
There can be no doubt that greater access to patients’ clinical information will elevate care delivery. By adopting technology that makes certain that the right provider has the right information at the right time to make the right decision for the right patient, healthcare organizations can greatly accelerate their efforts to improve both quality and patient safety.
Tamra E. Merryman, Chief Quality Officer, University of Pittsburgh Medical Center, can be reached at merrymante@upmc.edu.
This article can be found online at wpahospitalnews.com.