health information technology - presentation by kori krueger, md, faap
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Health Information Technology: AnInvaluable Tool for Managing Chronic
Diseases
Partnership to Fight Chronic Disease
Kori Krueger MD, FAAP
Marshfield ClinicNovember 15, 2011
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Copyright Marshfield Clinic 2011
Formed 1916
Physician led 501(c)3
783 physicians in 86 specialties
6,450 employees
56 regional sites374,468 unique patients/year
76K Medicare, 58K Medicaid
3,767,300 patient encounters/yr
Over $1 billion in annual revenue
Security Health Plan (170,000 Member
HMO)Division of Laboratory Medicine
Education Foundation
Research Foundation
Family Health Center FQHC (76Kpatients, 443K encounters annually)
Seven Dental Clinics in underservedareas
An Academic Campus of UW School ofMedicine and Public Health
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MISSION
The mission of Marshfield Clinic is to serve
patients through accessible, high quality
health care, research and education.
VISION
Marshfield Clinic will be the preferred systemof cost-effective, evidence-based, quality
health care. Through research, education and
standardization of quality, we will reduce the
burden of disease, disability and the cost for
our patients and communities.
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Marshfield Clinic is providing value in care for patients,
purchasers, and providers -
Cost
onSatisfactiSafetyQualityValue
There is a continuing need to work WITH patients to provide
safe, quality care that is satisfying to patients while controlling
costs in an effort to maximize value in the marketplace for allstakeholders.
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Chronic Disease Management
More than 75% of Medicare spending occurs in
patients with 4 or more chronic diseases. (CB0)
25% of Medicare beneficiaries consume 85% of the
Medicare expenditures. (CBO)
10% of the US population consumes 65% of all healthcare spending. (CMWF Health Affairs 2007)
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CMS Physician Group Practice Demonstration Project
Success of Marshfield Clinic in improving
quality while reducing cost
Highlights the importance of the EMR in
managing chronic disease in populations
EMR allows for the rapid and efficient
collection of data for feedback
Sets the stage for movement toward newmodels of care delivery such as ACOs
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Value in Chronic Disease Management: Use of the EMR
Goal: Use the EMR to improve the value of care for patients, the
care team, and payersImprove quality of care
Improve availability of information for clinical decision supportand shared decision making
Improve feedback to and communication within the care teamand Patient Centered Medical Home (34 NCQA level III sites)
Improve accessibility of health information for the patient andcare team (patient portals, visit summaries, HIEs)
Reduce costs (goal to reduce or eliminate unnecessary andredundant medical care)
Reduce or eliminate error in the healthcare experience
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Current vitals
Prevention
Services
Chronic Disease
Service Reminders
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Active Problems
Test Results
Allergies
Medications
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Upcoming Appts
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Directions to Portal
Place for Notes
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Ed tiF db k
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External influences
Public Reporting Health Care Reform
Payer Requirements
Education
Guidelines ICSI Computer based CME
Feedback
Dashboards
Population based
Patient Lists
By Condition Physician practice
Applications
Point of Care
Patient Dashboard
PreServPlanned Visits
iList
Patient Care
Patients Entering
the Care System
Better Value
Improved Patient Outcomes
Decreased Costs
New Models of Care
Patient Centered Medical Home Care Coordination
Accountable Care Organizations
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Summary
EMR can assist in the management of chronic
diseaseCollect and track quality metrics
Provide Point-of-care support to the care team
Promotes communication between care team membersEnables data collection for feedback to the care team
Enables patients to have access to EMR (portal)
Real-time care plan availabilityReduces redundancy in care leading to reduced costs