Cardiologists Use EMR Data to Save Lives
Vol. 1, Issue 1 - April 10, 2008
Centra Health, a two-hospital system with 587 total licensed beds in Lynchburg, VA won a $150,000 state grant for health information technology in January 2008. It will use the money to gather data from the organization’s electronic medical record to provide cardiologists with much-needed information about outpatient cardiac care, says Terri Ripley, Centra Health’s director of systems and programming.
“Right now, our physicians have access to inpatient quality data, but they would really like to be able to track what happens once cardiac patients leave the hospital,” Ripley says. “So much of care happens after that initial hospital visit.”
Joint Project with American College of Cardiology
Centra Health first applied for a health IT grant in September 2006 to help with its EMR implementation. Its entry was top rated, but didn’t win any grant money, explains Ripley. Then in November 2007, it applied again, submitting a joint project with the American College of Cardiology for use of its National Cardiovascular Data Registry Program for Improving Continuous Cardiac Care (IC3). This time, Centra Health won.
Centra Health is still in the planning stages, but once the data retrieval system is up and running, physicians will enter outpatient data into specialized templates. Those will be saved in a data repository, says Ripley. Clinicians will use a query tool to access quality data and information about best practices.
The resulting aggregated data will be part of the IC3, which will monitor how well physicians are following clinical practice guidelines.
“The goal is to improve the quality of outpatient care, and to do that, we use performance measures,” says John Spertus, MD, MPH, director of cardiovascular outcomes research at Mid America Heart Institute, professor of medicine at University of Missouri-Kansas City, and chair of the IC3 steering committee. “This registry is the first national effort to prospectively collect data, assess performance measures, and then feed that information back to the doctors at the time of care and in aggregate every three months.”
Although physicians at Centra Health will have primary access to information in the registry, other providers may be able to access it, Spertus tells Inside Healthcare Computing. He stresses that IC3 is the first step in what will eventually become a national registry.
Registry Accepts Both Data Entry, EMR Extraction
Centra Health chose to use a Web-based tool for patient data entry. However, Spertus says that information can be extracted from an EMR as long as it meets the necessary technical specifications. “We want to make sure that practices can participate without double entry,” Spertus says.
Centra Health pays someone to manually enter data for inpatient cardiac care, says Ripley. They are looking forward to skipping that step on the outpatient side.
“Physicians are very excited about this,” says Spertus. “It’s a big change and new paradigm for them.”
System Provides Patient Summary, Alerts, Recommendations
Before each appointment, the IC3 tool will provide a printout summary that contains information about medications, patient history, and past treatments. When the physician meets with the patient, he or she can use the letter as a guide and then record any recommendations for further treatment.
The system provides an alert if the patient should receive services that meet additional performance measures. For instance, if a cardiologist has not discussed smoking cessation, or has not discussed beta blockers with a patient who has coronary artery disease, the printout will give notice that a performance measure has been missed.
The registry will also include strategies for improving outcomes based on the particular needs of individual cardiac patients. It will provide case studies with detailed examples for physicians. Finally, the registry will assist providers in collecting accurate performance measures for participation in pay-for-performance programs.
Physicians Want Solid Quality Data
Right now, Centra Health is focused on the planning and development stages of the 18-month case study, says Ripley. “We have a lot to do, including the actual building, but when it’s complete, we’ll be able to understand outpatient care and improve outcomes in a way we couldn’t before,” she adds.
That a professional society is going to such lengths and pushing for this kind of data retrieval system demonstrates how much physicians want solid quality data and how willing they are to take the responsibility on themselves, says Spertus.
In the long term, the ACC hopes that insurance carriers will use the readily available quality data from the registry in lieu of administrative data.
“Registry data can show things that administrative data never could,” says Spertus. “For instance, a particular patient may not be eligible for a beta blocker because they have a certain condition. Administrative data would not show this and the carrier could assume the physician made an error. The rich, clinical data that we collect gives a much better picture of patient care.”
— Correspondent Maureen McKinney