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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).

Slide 1

Informatics and the New Healthcare System

Information Technology Will Provide the Platform for Quality Improvement in Healthcare for the 21st Century

Bruce Bagley
July 25, 2001

Slide 2

"Informatics in Medicine"

"The Integration of Computer Technology and Support Into Every Aspect of the Art, Science and Business of Medicine"

Slide 3

What Does the New Environment Look Like?

  • Cost conscious.
  • Customer driven.
  • Web connected.
  • Information rich.
  • Best practices known by all.
  • Patients will become informed purchasers.
  • Safety, quality and accountability expected.

Slide 4

We Simply Will Not Be Able To Provide High Quality Cost Effective Care Without Information Technology Support!

Slide 5

Information Technology Support for Clinicians Should:

  • Improve system consistency and reliability.
  • Assure precision in medication prescribing and distribution:
    • Avoid prescribing meds for allergic patients.
    • Alert clinicians to potential drug interactions.
    • Reliably transfer Rx information to pharmacy
  • Support appropriate patient education.

Slide 6

Barriers 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 the organization.
  • Requires information technology (IT) support often not available

Slide 7

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.

Slide 8

Electronic Medical Records (EMR)

  • 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.

Slide 9

Practice Management Software

  • Accounting and billing.
  • Scheduling.
  • Practice management reports.
  • Electronic claims submission.

Slide 10

EMR Functionalities

  • Intra-office messaging.
  • Prescription writing.
  • Order entry.
  • Lab result reporting.
  • Referral generation.
  • Super-bill/coding.

Slide 11

EMR Functionalities

Office visit entry:

  • Nursing note (visit agenda).
  • Vital signs.
  • Medication list:
    • Drug interactions.
    • Allergies.
    • Formulary compliance.
  • Physician's note:
    • Dictated, voice recognition, pick lists, keyboard.

Slide 12

Bonus EMR Functions

  • Genograms.
  • Flow sheets and graphing.
  • Consults and imaging reports.
  • Patient photographs.

Slide 13

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 and treatment.
  • Community-based EMRs and data warehousing.
  • Ongoing patient education and monitoring.

Slide 14

Using The EMR To Document Performance Measures

  • Relational data base allows data extraction.
  • Disease registries already in the system.
  • Physician specific data.
  • Outcomes measures.
  • Clinical research.
  • True test of competence.

Slide 15

"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.

Slide 16

Institute of Medicine (IOM) Report

"Crossing The Quality Chasm"

The Care should be:

  • Safe.
  • Effective.
  • Patient-centered.
  • Timely.
  • Efficient.
  • Equitable.

Slide 17

Flock Of Birds

This slide displays a flock of birds.

Slide 18

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.

Slide 19

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.

Slide 20

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

Internet Citation:

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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