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Data-Driven Medical Practice. Data-Driven Medical Practice. What are the needs? Patients health status health risks progress during treatment Physicians treatment decision support trends in disease management financial management Payers (commercial and government)
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Data-Driven Medical Practice What are the needs? • Patients • health status • health risks • progress during treatment • Physicians • treatment decision support • trends in disease management • financial management • Payers (commercial and government) • understanding of the burden of disease (population perspective) • assurance of quality for their customers/beneficiaries • fiscal responsibility to the system
Data-Driven Medical Practice What are the elements of data-driven medical practice? • Clinical measures in addition to traditional claims statistics • Data grouped in clinically meaningful patient cohorts – something more than traditional ICD-9, CPT & DRG coding • Longitudinal data collected consistently over time • Data focused on measuring clinical outcomes and monitoring adherence to practice pathways • Integrated data from provider and payor partners – let’s all understand the big picture • Clinical improvements driven by continual performance feedback
Data-Driven Medical Practice What do effective clinical data systems need? • Logic • organized around clinical thinking • algorithm-based features • Usability (aka “user friendliness”) • can people learn the processes • Some rigidity • there must be a basic foundation and certain required functions that are common to all systems, ie “data definitions” • Some flexibility • Data needs will evolve over time – the system needs the capacity to capture discrete data without substantive re-design • Avoid gimmicks • Multi-lingual (actually, “machine” language) • Can our black box talk to your black box?
Data-Driven Medical Practice • How does a practice implement an EHR? • Choose an EHR • Create a small committee of committed physicians and clinical users who will champion the system • Get a top-flight consultant who knows the system • Listen to the consultant • Use the system as it is designed – there is no perfect system – get over it! • This may mean that you need to rethink your work flow – heavens! • Establish consistency within the practice • EVERYone must use the system at a minimum threshold • Reach agreement on where and how data will be stored and retrieved – all users must comply • It won’t happen over a weekend