Kaiser’s EMR brings better data, HEDIS scores
Major computer investment pays off in outcomes
When a California collaborative recently issued a report on the state’s health plans, Kaiser Permanente was the only one with above-average scores in every category. The secret of its success: an electronic patient record that helps physicians track care delivery and outcomes and enables the health plan to report accurate data.
Unlike other health plans around the country, Kaiser Permanente in northern and southern California can submit most Health Plan Employer Data and Information Set (HEDIS) effectiveness of care data without pulling medical charts.
"I believe that those results demonstrate a better ability to capture data and a better ability to provide care in these areas," says Tracy Rodriguez, MPH, MBA, director of performance reporting for Kaiser Permanente in Oakland.
Kaiser will spend hundreds of millions of dollars in the next three to five years to implement electronic records nationwide, says Michael Ralston, MD, director of quality demonstration for the Permanente Medical Group of Northern California. "We believe that clinical information systems development is extraordinarily important," he says.
At Kaiser, every physician has a computer terminal on his or her desk with on-line access to a patient’s visit histories, lab results, X-ray and diagnostic imaging, pharmacy records, hospitalizations, and immunization history. Physicians can quickly learn whether the patient is due for preventive care, such as a mammogram, and receive an alert for possible drug interactions or allergies and other concerns. "Most of our systems are capturing [data] right at the point of service," says Rodriguez.
Kaiser creates "individual practice management" reports for physicians detailing the care given to groups of patients such as diabetes or those with congestive heart failure. Other reports reveal outcomes such as the stage of cancer at diagnosis.
The next phase will incorporate narrative text: written progress notes, hospital discharge summaries, and written consultant reports. While physicians still look at paper as well as computer screens, gradually the paper record will become obsolete and the electronic health record will contain all pertinent information, says Ralston.
Kaiser also plans to implement decision support, which would calculate risk profiles and issue recommendations on care.
The HEDIS reporting is a sidelight to the clinical benefits of electronic records, says Rodriguez. "HEDIS is just a proxy for making health improvement on a population basis," she says.
Kaiser spends about $1 million a year collecting and submitting HEDIS data in California, a figure that would be much higher if the health plan conducted massive medical record reviews, Rodriguez says.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content