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The Next Revolution: The Role of Informatics in Improving Health Care
Informatics and the New Healthcare System
Slide Presentation by Bruce Bagley (Text Version)
On July 25, 2001, Bruce Bagley, M.D., made a presentation during the Web-assisted teleconference, The Next Revolution: The Role of Informatics in Improving Health Care entitled "Informatics and the New Healthcare System."
This is the text version of Dr. Bagley's slide presentation. Select to access the PowerPoint® slides (2.3 MB).
Informatics and the New Healthcare System
Information Technology Will Provide the Platform for Quality
Improvement in Healthcare for the 21st Century
July 25, 2001
"Informatics in Medicine"
"The Integration of Computer Technology
and Support Into Every Aspect of the Art, Science and Business of Medicine"
What Does the New Environment
- Cost conscious.
- Customer driven.
- Web connected.
- Information rich.
- Best practices known by all.
- Patients will become informed purchasers.
- Safety, quality and accountability expected.
We Simply Will Not Be Able To Provide High Quality Cost
Effective Care Without Information Technology Support!
Support for Clinicians Should:
- Improve system consistency and reliability.
- Assure precision in medication prescribing and distribution:
prescribing meds for allergic patients.
clinicians to potential drug interactions.
transfer Rx information to pharmacy
- Support appropriate patient education.
To Acceptance of Redesign Ideas
- Most physicians are currently overwhelmed.
- Change takes new or reallocation of resources.
- Long rather than short return on investment (ROI).
- Often will require significant "culture change" within
- Requires information technology (IT) support often not
Barriers to Acceptance
of Information Technology
- Lack of organization and systems thinking in the current
practice of medicine.
- Fear of reduced productivity in a narrow margin business.
- No apparent financial incentive to change.
- Financial barriers—no capital.
Electronic Medical Records
- Add to office efficiency.
- Reduce errors and miscommunication.
- Allow population management.
- Automate protocols and reminders.
- Offer just in time education.
- Provide decision support.
- Have the potential to test competence.
- Accounting and billing.
- Practice management reports.
- Electronic claims submission.
- Intra-office messaging.
- Prescription writing.
- Order entry.
- Lab result reporting.
- Referral generation.
Office visit entry:
- Nursing note (visit agenda).
- Vital signs.
- Medication list:
- Drug interactions.
- Formulary compliance.
- Physician's note:
- Dictated, voice
recognition, pick lists, keyboard.
Bonus EMR Functions
- Flow sheets and graphing.
- Consults and imaging reports.
- Patient photographs.
The Role of The Internet
in the Future Practice of Medicine
- Patient access to providers: E-mail to your primary care physician.
- Patients using the Internet to learn about their own symptoms or disease.
- Physicians accessing the latest evidence-based information related to diagnosis
- Community-based EMRs and data warehousing.
- Ongoing patient education and monitoring.
Using The EMR To Document
- Relational data base allows data extraction.
- Disease registries already in the system.
- Physician specific data.
- Outcomes measures.
- Clinical research.
- True test of competence.
"Crossing The Chasm"
This slide displays a picture of the Institute of Medicine Report entitled
Crossing the Quality Chasm: A New Health System for the 21st Century.
Institute of Medicine
"Crossing The Quality
The Care should be:
Flock Of Birds
This slide displays a flock of birds.
IOM's Ten Principles
- Based on continuous relationships.
- Customized to patients' needs and values.
- Control resides with the patient.
- Sharing knowledge with the patient.
- Clinical decisions should be evidence based.
IOM's Ten Principles (continued)
- The care system should be safe.
- The health system should be transparent.
- The system should anticipate patient needs.
- The system should not waste resources or patients' time.
- Cooperation to ensure exchange of information and coordination of care.
Primary Care Business Model
- Seldom has business plan or future strategy.
- No contribution to capital reserves.
- Narrow margin business.
- Risk averse.
- Little motivation to change.
- Physicians try to provide management while maintaining full clinical responsibilities.
Current as of August 2001
Bagley, B. Informatics and the New Healthcare System. Slide Presentation (Text Version) presented at The Next Revolution: The Role of Informatics in Improving Health Care, Web-Assisted teleconference, July 25, 2001. Agency for Healthcare Research and Quality, Rockville, MD.
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