HIT Perspectives

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    HIT Perspectives – November 2021

    Leveraging EHRs to Close Gaps in Care and Improve Quality

    Brian-Bamberger-cirBy Brian Bamberger, Life Sciences Practice Lead

     

    Quick Summary

    • EHR functionalities, generally unfamiliar to providers, may help close gaps in care
    • Pharmaceutical field teams are well positioned to help providers to understand and use these functionalities in their workflow
    • EHR tools related to patient identification, communication and health maintenance are critical

    Electronic health records (EHRs) have functionalities that can help providers close gaps in care and supply analytics to track and measure improved care quality. Yet, providers may not know these functionalities exist, how to activate them or the steps necessary to set them up correctly. This presents an opportunity for pharmaceutical field teams to help clients automate clinical processes and leverage tools in their EHRs to address patient needs and practice quality goals.

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    Now is a good time for such engagement. Closing care gaps and outcomes improvement are metrics that are tied to Medicare and other private payers’ incentive programs and are necessary for the viability of the growing number of value-based care organizations. As providers struggle to recoup revenue losses incurred during the COVID pandemic, a focus on closing gaps in care and outcomes can translate to much needed practice revenue.

    COVID fears significantly reduced the number of patients seeking care over the past 18 months. For example, roughly half of adults reported delaying care during the pandemic. Routine screenings suffered as well, with preventive cancer screenings down by roughly 90%. This created gaps in care and quality issues for many patients. Computerized tools can be instrumental in helping patients make up for lost time in exams, screenings and treatments. Research shows that providing high-quality care is a goal of many practices. Leveraging EHR functionalities can help them achieve that goal. Field teams can engage with physicians to position them for success through the use of existing EHR tools.

    EHR tools. Several EHR tools can assist physicians in using EHRs to close gaps in care and improve quality.

    • Patient identification. EHRs’ analytics capabilities query clinical information and help identify patients to target for treatment or treatment intensification. This is especially important for clinicians managing high-risk patients and the chronically ill. Delayed or avoided treatment of these patients can lead to increased morbidity, mortality and poor health outcomes. Data analytics increasingly will become a tool to prioritize social determinants of health, which impact populations that do not have the same access or equity in care availability and treatment as other populations. These will be a focus of the federal government in the near future and a growing part of public health monitoring and reporting going forward.
    • Patient communication. Some EHR functionalities can automate routine communications and take the burden off staff for scheduling needed screenings and visits. Patients can be reached via automated telephone calls, texts, secure emails and smartphone apps. Practices can set up their EHRto automatically send out letters or secure emails to some or all patients to remind them of due or overdue care. Targeted and personalized communications can increase patient engagement and improve patient satisfaction, patient retention and outcomes. Patients are more reachable electronically than ever due to the proliferation of mobile applications in response to recent government mandates.
    • Alerts/reminders/health maintenance. These are “kissing cousins,” which are related but have distinct differences in how they reach and interact with EHR users.

    Alerts are “synchronous,”  meaning they display in the EHR immediately in response to provider actions. For example, they can indicate such things as adverse drug interactions when a medication is prescribed at the point of care. Alerts are typically reserved for “patient harm” events requiring the attention of the provider. EHRs can be equipped with all kinds of alerts, which must be tailored to the needs and workflows of the individual user and made actionable. Otherwise, "alert fatigue" may set in and the alerts might be ignored.

    Reminders, also synchronous events, are triggered by a time parameter or clinical indication such as the need for an immunization. Reminders are typically used to prompt providers that certain events are due or overdue (such as an annual exam or screening), but are not patient-harm events. Reminders can be set up to require an acknowledgment before the user can proceed, thus adding time to the physician’s workload and creating possible frustration with the process. In addition, one size does not fit all. What is an appropriate reminder for a pediatrician can be irrelevant for a cardiologist. As a result, EHRs must be set up for different roles and settings and be actionable, which is important for care teams and providers working in integrated delivery networks. Otherwise, reminders can contribute to alert fatigue and become a barrier to care. 

    Health maintenance entails a series of passive reminders that track such current and outstanding health measures as exams and screenings. It is similar to reminders, except that a list of health maintenance reminders must be intentionally viewed instead of displaying automatically. Outstanding health maintenance items are automatically updated based upon information documented in a patient's chart. Leveraging health maintenance is a way to provide clinically appropriate treatment to improve care quality.

    Regardless of the type of alert/reminder/health maintenance, providers must decide how often they wish to receive these reminders and under what circumstances, balancing the clinical importance of the information with available patient time and alert fatigue.

    Alerts/reminders and health maintenance are strong tools to identify when the patient is due or past due for follow up and enables the provider to reach out by mail, phone or electronic means. Pharmaceutical field teams can help providers determine which of these functionalities and content are available in their EHR and help tailor them to a provider’s specific needs and even to those of specific patients. 

    Other opportunities. These are not the only opportunities for field teams to help physicians leverage EHR functionalities that translate into streamlined workflows, care gap closure and high-quality care. Point-of-Care Partners (POCP) offer EHR resources for your field teams to provide to your health care providers, positioning them as trusted partners with their health care customers. These resources support customer implementation and optimization of your brand in their EHR – across the continuum of care – so your customers can more easily manage the care and education of their patients.

    We help you position your customers for success and provide the tools to make it happen. Want to know more? Reach out to me at brian.bamberger@pocp.com.