How Can I Use Health IT for Quality Improvement in HIV/AIDS Care?
You can use health IT as a tool in conjunction with wider efforts to improve quality in HIV/AIDS care. Importantly, health IT promotes quality improvement by allowing you to better track and manage chronic diseases. Disease registries, which provide the capability to track both individual patients and populations of patients with certain conditions, are among the most frequently applied health IT tools in HIV/AIDS care. These registries can help you to manage chronic illness, improve care coordination, and ensure that preventive care guidelines are followed (for example, by assisting providers to identify patients most in need of intervention).
Other types of health IT capable of supporting quality improvement include Electronic Health Records (EHRs), Clinical Decision Support (CDS) systems, and practice management systems. Health IT can provide you with access to timely and accurate clinical information that will support personalized care for your patients.
CDS systems provide clinicians with clinical knowledge that is based on accepted clinical guidelines to enhance patient care and patient safety. This knowledge may be presented to providers through a variety of tools and interventions, including computerized alerts and reminders, patient data reports, and templates for documenting patient information. CDS systems can prompt providers to order recommended preventive health screenings and tests or notify providers of medication interactions that may have harmful effects. For example, your CDS system could alert you to the date of a woman’s most recent test for cervical cancer, and then prompt you to contact the patient to schedule or perform that test. Certified EHR technology for the CMS Incentive Programs must be capable of computerized physician order entry (CPOE), e-Prescribing, and other clinical decision support.
Health IT can also support your patient monitoring efforts. For example, your EHR system may graph a patient’s viral load over time so that you can spot trends and abnormalities. It can also allow you to share information with your patients’ other providers to help coordinate their care. The efficiencies gained from using these technologies can allow you to reduce your and your patients’ costs, as they can eliminate your costs of maintaining and filing medical charts, and patients’ costs for unnecessary or inappropriate laboratory tests. Avoidance of unneeded laboratory tests will benefit payors as well.
In addition, health IT tools support the medical home model of care. This model promotes partnerships between individual patients and their personal physicians. It emphasizes patient-centered care and strives to have patients actively participate in their care. Health IT provides a comprehensive medical record, patient education and information, and enhanced patient communication with providers. It also can give patients easy access to their own medical information, which is vital for helping them with medical decision making and managing their own health conditions. Personal Health Records (PHRs) and patient portals have been used successfully by practices that transformed themselves into a medical home.
HRSA and HAB have sponsored several major quality-of-care initiatives that promote the use of health IT. These initiatives include the HIVQUAL Continuous Quality Program, the National Quality Center , HIVQUAL-US , the HRSA Minority AIDS initiative, and the HRSA Special Projects of National Significance. You can find additional information and useful resources in each of these programs’ websites.
Also, the Federal government’s EHR Incentive Programs promote meaningful use of heath IT, with the goal of improving the quality of healthcare. Under the Health Information Technology for Economic and Clinical Health Act, or the “HITECH Act,” EHR incentive payments are being offered to qualified Medicare and Medicaid providers. Providers that are eligible for these incentive payments include those practicing in federally qualified health centers (FQHCs), Rural Health Clinics (RHCs), and private practices. Hospital-based providers, defined as providers who have more than 90 percent of their Medicaid or Medicare volume provided in an inpatient hospital or emergency room, are excluded from participating in this program.
The incentives are to help purchase, upgrade, and implement EHR technologies and to use them in a “meaningful use way.” To qualify for the incentive payments, you must adopt and use an EHR that has been certified as meeting standards set by the Office of the National Coordinator for Health IT (ONC). You must also demonstrate Meaningful Use of EHRs by fulfilling 20 functional objectives for eligible professionals and 19 for hospitals and measures and report on six clinical quality measures.
National Quality Center – This website provides Ryan White Program grantees with quality management publications, HIV indicators, slide presentations, best practices, and training curricula. Included are ways in which technology can improve the quality of care.
HIVQual – This website offers tools for building capacity to improve the quality of HIV care. It provides information on performance measurement strategies, sampling methodology, and data collection and reporting to improve quality.
Quality Improvement and Risk Management Training – These HRSA learning series provide an introduction to quality improvement and risk management. They include a section to assist you in planning for Quality Improvement (QI) and applying QI policies and practices, guidance on implementing quality metrics, and an overview quality reporting tools.
Clinical Information System Changes for Improvement – This Institute for Healthcare Improvement module focuses on the application of disease registries to promote quality improvement.
Health Information Technology for Improving Quality of Care in Primary Care Settings – This AHRQ resource addresses the relationship between health IT and quality improvement in patient care.
HRSA Ryan White HIV/AIDS Program Part A Manual – This HRSA manual discusses clinical quality management for Ryan White HIV/AIDS Program participants.
Clinical Decision Support – This AHRQ website on its Clinical Decision Support (CDS) Initiative includes information on CDS research projects and outreach efforts and offers links to CDS articles, white papers, podcasts, and implementation guides.
Overview of Clinical Quality Measures – Centers for Medicare and Medicaid Services (CMS) webpage lists the core, alternate core, and additional clinical quality measures required for demonstrating Meaningful Use.
Standards and Certification Criteria – The Office of the National Coordinator for Health Information Technology’s (ONC’s) initial set of standards, implementation specifications, and certification criteria for the EHR Incentive Program.
Certified Health IT Product List – This ONC webpage lists those EHR technologies that have been certified for the EHR Incentive Program. The list includes the product name, vendor information, product information, and product version number.
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