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Michel le P ichardo, MPH
September 30 , 2010
Quality Reporting and Quality Improvement
Learning Objectives
How can electronic health record systems accelerate data collection for monitoring and improving quality?
Who are the key members that assist in monitoring quality data/reports and how is the information shared throughout the organization?
Now that your organization has access to data for quality reporting, how do you translate that into meaningful use?
HIE
EpicCare Link
Patient Portal
Quality Reporting/Improvemen
t
Clinical Decision Support
Goal of Quality Improvement
To reach the state of TQM (Total Quality Management).
Where all aspects of the organization are working towards improving quality.
Get to Know Your Data
Build a Data Dictionary
7
Define All Key Elements Captured by the EHR
Patient AddressRace / Age / GenderMedical history Social history
Provider LocationReason for visitProblem list
TemperatureBlood pressureHeight/weightRespirations
ProceduresMedicationsLab resultsDiagnoses
Take the Time to QA the Data
Document and Define the Measures and Metrics
Identify the specific parameters.
Share with project team.
Review a test run of the report.
Decide how often the report with run.
A mountain full of data yet a finite amount of resources to handle it.
Target measures and target resources in the most efficient ways possible.
Quality Improvement Team
President & CEO – Neil Calman, MD
CIO - Weston Willett
CMIO - Joseph Lurio MD
Sr. Vice President – Robert Schiller, MD
VP Clinical Affairs- Nicole Nurse, RN
Quality Reporting Analyst - Kwame Kitson MD
Quality Reporting Examples
TCNY reports
UDS and IDS reporting
Diabetes and HIV disease registries
Risk stratification system
Site lead quality improvement initiatives
0
10
20
30
40
50
60
70
80
90
100
ALL
Percentage
BMI Screening
Depression Screening
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10
20
30
40
50
60
70
80
90
100
ALL
Percentage
0
10
20
30
40
50
60
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100
ALL
Percentage
Colon Cancer Screening
86.8%
13.2%
Patients with HTN controlledPatients without HTN controlled
Hypertension Control
0.9% 0.0% 0.2%
21.7%
0.2%
49.8%
3.0%
23.5%
Asian
Native Hawaiian
Other Pacific Islander
Black/African Descent
Native American/AlaskanWhite (Non-Hispanic)
More than one race
Unknown/Unreported
Hypertension Control by Race1
1 UDS Measure, 2009
20.1%
79.9%
Hispanic patients with HTN controlledNon-Hispanic Patients without HTN con-trolled
Hypertension Control by Ethnicity
Disseminating the results
Other key points
Set reporting priorities
Participate in team member meetings
Maintain good documentation
Thank You
Contact Information:
Michelle PichardoEmail: [email protected]
Phone: 212-633-0800 ext.1279
