Bringing Measurement to the Point of Care

说明(由申请人提供)：该项目的总体目标是能够对护理质量进行有意义的衡量，重点放在公共卫生优先问题、弱势人口和小型办公室做法上。纽约市卫生和精神卫生部门的初级保健信息项目寻求利用卫生信息技术在这些领域，特别是在弱势群体中，在全人口范围内衡量和改善临床护理。作为这项为期3年、耗资3000万美元的市长倡议的一部分，1000多名医疗提供者将获得具有增强的预防保健功能的电子健康记录(EHR)。流动电子病历产品将包括Epic(Tm)、NextGen(Tm)、GE Centricity(Tm)和eClinicalWorks(Tm)。临床合作伙伴包括纽约市所有获得联邦资格的医疗中心、几个医院门诊部和数百家小型办公室的初级保健提供者，包括通过医生办公室质量-信息技术(DOQ-IT)项目整合的实践子集。所有实践都致力于参与全市范围的质量报告倡议，通过一套标准的自动化EHR启用的临床质量衡量标准来解决公共卫生优先问题。已经制定了一套旨在解决优先公共卫生问题的候选临床质量措施，并从城市家庭健康研究所建立了这些措施的自动报告，这是一个获得联邦资格的社区卫生中心网络，全面实施了电子健康记录。作为该项目一部分进行验证的指标将在全市范围内使用 报道主动权。成功的启用电子病历的质量测量需要医生在护理时记录相关信息。为了减轻与数据收集相关的负担，并使医生能够实现质量目标，该项目将设计和测试一种简单而直观的“质量仪表盘”，适用于小型办公室实践，它将在护理点集成质量测量和临床决策支持。仪表板将向医疗提供者显示患者属于哪个测量队列，以及他们的护理是否符合筛查和治疗建议，而集成的决策支持工具将使提供者能够采取适当行动，使措施符合要求，或由于有效的排除或禁忌症而将患者从测量队列中移除。

DESCRIPTION (Provided by the Applicant): The overall goal of this project is to enable meaningful measurement of the quality of care, with a focus on public health priority issues, disadvantaged populations, and small office practices. The New York City Department of Health and Mental Hygiene's Primary Care Information Project seeks to use health information technology for population-wide measurement and improvement of clinical care in these domains, particularly among disadvantaged populations. As part of this 3-year, $30 million Mayoral initiative, over 1,000 medical providers will be receiving electronic health records (EHRs) with enhanced preventive care functionalities. Ambulatory EHR products will include Epic(tm), Nextgen(tm), GE Centricity(tm), and eClinicalWorks(tm). Clinical partners include all of New York City's federally qualified health centers, several hospital outpatient departments, and hundreds of primary care providers in small office settings, including a subset of practices assembled through the Doctor's Office Quality-Information Technology (DOQ-IT) project. All practices have committed to participating in a citywide quality reporting initiative with a standard set of automated EHR-enabled clinical quality measures that address public health priority issues. A set of candidate clinical quality measures designed to address priority public health issues has been developed, and automated reporting of these measures has been established from the Institute for Urban Family Health, a federally qualified community health center network with a comprehensive EHR implementation. The indicators validated as part of this project will be used in a citywide quality reporting initiative. Successful EHR-enabled quality measurement requires that physicians document relevant information at the point of care. In order to reduce the burden associated with data collection and empower physicians in attaining quality targets, this project will design and test a simple and intuitive "quality dashboard" suitable for small office practices that will integrate quality measurement and clinical decision support at the point of care. The dashboard will show medical providers which measurement cohorts the patient belongs to and whether their care complies with screening and treatment recommendations, while the integrated decision support tools will enable providers to take appropriate action to bring the measure into compliance, or remove the patient from the measurement cohort due to valid exclusions or contraindications.