usingHealthInformationTechnologytoImproveCareEvidence.ppt

Using Health Information Technology to Improve Care: Evidence and Strategies Overview Need for Healthcare Change Drivers of Change in VA VA IT Infrastructure Using HIT to Implement Evidence Strategies RAND Study:Quality of Health Care Often Not Optimal We provide appropriate health care only about half the time! Implementation of Research Findings: “Debunked Assumption” IOM, NAE and the IT Revolution Veterans AdministrationOrganizational and IT Infrastructure VA’s Health Information System is “VistA” VA runs 128 VistA systems Down from 172 VistA systems 10 years ago 180,000 PCs and thin clients “CPRS” is the integrated EHR application Delivers a complete hospital information system - Electronic health record - Imaging - Bar-code medication administration Hardware, software, maintenance, upgrades, staffing VA’s Health Information System is “VistA” For FY2004: Cost per enrollee - $78 / enrollee Average cost per hospital (n=158) - $3.6 million Success In Supporting Care Delivery For Millions Of Veterans VistA is a success Built by “fire” of VHA collaboration Publicly owned by VA Strong interest by public/private in using VistA National software w/ local flexibility/innovation: Innovation developed locally enterprise wide Standard packages distributed enterprise wide Articles About VA’s Info Technology Quality Care Using HIT to Implement Evidence Systematic Review: Impact of HITon Quality, Efficiency, and Costs of Medical Care Most of high-quality literature regarding multifunctional HIT systems comes from 4 benchmark research institutions. Little evidence available on effect of multifunctional commercially developed systems. Little evidence available on interoperability and consumer HIT. HIT shown to improve quality by:- increasing adherence to guidelines,- enhancing disease surveillance, - decreasing medication errors. Much evidence on QI relates to 1° and 2° preventive care. Major efficiency benefit has been decreased utilization of care. Ef