EHR-Based Measurement of Care Coordination in an Accountable Care Organization

项目概要/摘要 最近，医疗费用的增加和医疗保健的下降，特别是在慢性病患者中， 导致了重大的卫生保健提供和支付改革举措。改革的一种方法包括 建立负责任的保健组织、提供者和保健团体 为特定患者群体提供协调护理的组织。有效的护理协调 有可能通过减少可预防的医院来实现质量改进和成本控制 入院和再入院，减少急诊科就诊，改善护理过渡。 然而，不存在能够产生全面的、实时的、 护理协调的可量化测量。我们的长期目标是改善护理协调 通过ACO来改善慢性病患者的结局并降低其成本。我们的整体 R 03建议的目标是实施基于EHR的护理协调措施，制定 框架，说明在ACO背景下衡量护理协调的关键领域，并绘制每个 将基于EHR的措施应用于框架域。我们计划通过以下方式实现我们的总体目标： 追求以下两个具体目标：1）实施基于EHR的措施，以评估护理协调 2）制定和映射基于EHR的措施，以建立ACO护理的关键领域框架 协同这一提议意义重大，因为它扩展了先前的研究， 全面，更准确的ACO评估，因此可以帮助确定护理领域 在电子健康记录和ACO中可以改善协调，以改善医疗保健 降低患者的成本。

Project Summary/Abstract Recently increasing costs and declining health care, particularly in patients with chronic diseases, have led to major health care delivery and payment reform initiatives. One approach to reform includes the establishment of accountable care organizations (ACOs), groups of providers and health care organizations who deliver coordinated care to a defined patient population. Effective care coordination has the potential to achieve quality improvement and cost control by reducing preventable hospital admissions and readmissions, decreasing emergency department visits, and improving care transitions. However, no single measure or set of measures exists that is able to produce comprehensive, real-time, quantifiable measurements of care coordination. Our long-term goal is to improve care coordination through ACOs to improve outcomes and reduce costs in patients with chronic diseases. Our overall objectives in this R03 proposal are to implement EHR-based care coordination measures, develop a framework illustrating key domains for measuring care coordination in the ACO context, and map each of the EHR-based measures to the framework domains. We plan to accomplish our overall objective by pursuing the following two specific aims: 1) Implement EHR-based measures to assess care coordination in an ACO, and 2) Develop and map EHR-based measures to a framework of key domains for ACO care coordination. This proposal is significant, because it extends prior research to facilitate timelier, more comprehensive, and more accurate ACO evaluations, and, as a result can help identify areas of care coordination that can be improved in both electronic health records and ACOs to improve health care quality and reduce costs in patients.