Health Care Quality: Major Issues

1. Health Care Quality: Major Issues • Patient safety (IOM: 45,000-98,000 avoidable hospital deaths) • Low international performance on preventable deaths (Commonwealth Fund,: U.S. has highest number of preventable deaths among 19 leading industrialized nations) • Mis-alignment of financial incentives in relation to known and effective treatment • Failure to receive more than half of recommended treatments (Rand) • Failure to rapidly and equitably diffuse information related to promising interventions • Disparities in health care that cannot be explained by clinical evidence, coverage, or confusion over effective treatments • Excess costs attributable to payment for unsafe practices • Patient safety incidents between 2004-2006 cost Medicare an estimated $8.8 billion and resulted in 238,337 potentially preventable deaths. The George Washington University School of Public Health and Health Services The Institute for Health Policy at MGH/Partners Health System Division of Internal Medicine at the Brigham & Women’s Hospital Clinical and Quality Analysis Group of Partners HealthCare System

2. HIT as a Quality and Efficiency Tool Can help promote quality at potentially all levels of the health care system: patient, practice, institutional, community, and societal Error reduction and avoiding adverse events (e.g., e-prescribing & decision support potential to reduce medication error rates 50-90%) Improved access to timely information regarding choice of clinical treatment Greater patient access to better treatment information Ability to more closely examine practice, institutional, community, and regional variations in costs, quality, outcomes, and and information about, treatment information and options PHRs allow consumers to become more actively involved in their healthcare The George Washington University School of Public Health and Health Services The Institute for Health Policy at MGH/Partners Health System Division of Internal Medicine at the Brigham & Women’s Hospital Clinical and Quality Analysis Group of Partners HealthCare System

3. What Makes HIT an Important Quality Tool? • Collection of technologies (with certain “core functionalities”) tied to an EHR, defined in federal law as a “repository of consumer health status information in computer processable form and used for diagnosis and treatment” • Key core functionalities that enable the acquisition, ordering, use, and creation of information : • Health information and data • Results management • Order entry and support • Decision support