Healthcare quality initiative shuns high-tech for now

Healthcare quality initiative shuns high-tech for now

The Wisconsin Collaborative for Healthcare Quality has been chosen to lead an effort to report medical outcomes in physician and clinic settings, but participation will not necessarily be based on the level of technology investment.
WCHQ will be part of a federal pilot project to develop a practical method of collecting performance data from physician practices and present it in a format that is useful to both physicians and consumers. While the vision for this information exchange will take time to develop, participating physicians and clinics need not implement electronic medical records.
Michael Barbouche, who serves the collaborative as a loaned executive from the University of Wisconsin Medical Foundation, sees the value in collecting information from a variety of physician groups: “high tech, low tech, or no tech.”
“The ability and need to report shouldn’t necessarily be contingent on whether you have spent the big bucks on having a full-blown EMR implementation,” Barbouche said.
The WCHQ, which includes 21 healthcare providers, was formed three years ago to establish reporting of qualitative data. The organization has established a Web-based reporting format.
The Ambulatory Care Quality Alliance selected the WCHQ for the pilot, and the effort will proceed with funding from the Centers for Medicare & Medicaid Services and the federal Agency for Healthcare Research and Quality. In the preparation of its proposal, the collaborative characterized its membership as a blend of high technology and low-technology electronic environments. The membership includes Milwaukee’s Advanced Healthcare, which is quite far along in its adoption of electronic records, and others that are not nearly as advanced.
Christopher Queram, chief executive of the WCHQ, said one objective of the pilot program is to gain experience with the aggregation of data in both low-tech and high-tech physician office environments. Another is to engage smaller practice sites, primary care clinics of five, 10 or even solo physicians, which typically use paper records.
Queram said the organization is already aggregating performance data without using electronic records. Reporting comes from both automated retrieval and, in some cases, detailed narrative extraction.
“If nothing else, we have shown that with a focus on a core set of measures and with sort of the administrative and clinical leadership behind the undertaking, that it is possible to collect and report on physician performance without electronic records,” he said.
In time, one of the goals is to make medical best practices available to physicians in some electronic form, but the potential of electronic records still is a long way off. This year, the collaborative would like to establish a working relationship with a software vendor, such as Madison’s own Epic Systems, that designs electronic records for physician offices. Queran’s sense is that the healthcare industry has yet to reap the benefits of electronic records in a meaningful way.
The pilot will not only attempt to measure and report quality, but also bring more standardization to, and reduce variation in, the practice of medicine. Communicating best practices throughout an organization is a recognized role for the application of information technology. “I think there is no question that technology will play a role, and the use of technology will make quality in healthcare far better,” Barbouche said. “I don’t know that it’s necessarily a silver bullet.”
How do you know what kind of information technology your healthcare organization needs? The Digital Healthcare Conference in May will discuss this and more of the decisions driving healthcare technology today.