The Next Revolution: The Role of Informatics in Improving Health Care

Informatics and the New Healthcare System

Slide Presentation by Bruce Bagley (Text Version)

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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).

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Slide 1

Informatics and the New Healthcare System

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

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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. https://www.ahrq.gov/news/ulp/informat/bagleytxt.htm

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