The IHI conference keeps charging along, with lots of interactive sessions built around one of the organization’s core themes, “All Teach, All Learn.” Yesterday included 25 daylong mini-courses focusing on everything from decreasing rehospitalizations to designing a patient-centered medical home. All the topics were compelling, but in the end, I chose to sit in on “When Two Worlds Collide—Bringing Improvement and Health IT Together.”
Enhancing quality and patient safety has been on everybody’s radar screen big time since the IOM released its study on medical errors a decade ago, but “we’re still harming patients at an unconscionable rate,” said Laura Adams, president and CEO of the Rhode Island Quality Institute. Brian Robson, M.D., an IHI Health Foundation Improvement Fellow, noted that up to 67 percent of admission charts include unintended discrepancies.
While health IT is no panacea, Adams acknowledged, providers “are mired in a paper-based system” that sabotages even their best intentions at making patients safer. Robson cited data showing that 83 percent of ambulatory care providers and 90 percent of hospitals do not use an electronic health record.
The billions of dollars in federal funds earmarked for health IT could be a turning point, and Adams offered a detailed description of how those funds will be used to spur a national EHR. Especially noteworthy: the feds plan to identify 15 “beacon communities,” places that have already established themselves as leaders in health IT. They will receive a total of $235 million to move their efforts forward and will serve as models for the rest of the nation.
The government is also funding regional extension centers to work on-site in physicians’ offices to help implement EHRs. Adams is impressed with how integrated the government initiative is compared to previous efforts, when “you couldn’t tell if anybody involved had even talked with each other.”
Despite all the money available, don’t expect a stampede of doctors to sign up. “Medicine is a cottage industry,” Adams said, “and information moves very slowly.” She figures maybe half of all physicians don’t even know the money is out there to help them wire up and that many who do figure it’s another government mandate they want no part of.
She recommended that health care leaders adopt the “diffusion of innovation” theory: identify “peer innovators” in your state or community, doctors who are respected by their fellow physicians and who, through an innate interest in technology and a commitment to improve care, are early adopters of IT. Spread the word about their accomplishments and their peers are more apt to say, “If they can do it, I can do.”
This mini-course included much, much more useful information, including real-life safety improvement stories from executives at Duke University Health System, Geisinger Health System and Kaiser Permanente. Slides of the presentation are available at www.ihi.org/forum. This was session M19.
Bill Santamour, managing editor of H&HN, is blogging from the IHI Conference.
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