Ten research projects aimed at using health IT to improve care in ambulatory settings for patients with complex healthcare needs demonstrated improvements in care coordination, data sharing and patient engagement.
Called the Improving Management of Individuals With Complex Healthcare Needs Through Health IT initiative, it's one of five grant programs from the Agency for Healthcare Research and Quality (AHRQ) focused on using health IT to improve care.
The projects tackled a range of issues, including medication management, heart disease, mental illness and frailty associated with old age, according to a new report. They were designed to support shared decision-making, communication during care transitions, and secure exchange of information across multiple settings of care.
These included enhancing electronic health record systems with decision support to ensure timely diagnosis and improved medication reconciliation, designing health information exchange systems and secure messaging to ensure that information is shared across clinicians to improve the coordination of care, using automated phone calls to follow up with patients after a hospital discharge, and using personal health records to promote self-care and to help patients prepare for visits with clinicians.
Several projects showed a positive impact on clinician acceptance and use of health IT, as well as improvement in the flow of information when patients transitioned from one clinician to another. Other projects demonstrated high levels of patient engagement and participation in self-care. Still others reported reductions in hospital or emergency department (ED) use, the report says.
Some projects encountered barriers, such as integrating health IT interventions into existing clinical data systems, while others achieved successes through careful implementation and staff training. The lessons learned from these projects can be used to guide other efforts to better serve patients with complex conditions, the authors say.
Looking at 24 projects funded under its Improving Quality Through Clinician Use of Health IT (IQHIT) initiative, the AHRQ found that health IT systems such as clinical decision support, clinical workflow support and care coordination can improve healthcare outcomes. The technology itself, though, doesn't bring improvement, it said. However, technology can enhance physicians' ability to deliver appropriate evidence-based preventive and chronic care.
The AHRQ and a survey from the National eHealth Collaborative have stressed the importance of patient engagement in improving healthcare. AHRQ has urged use of health IT to enhance quality measurement including engaging patients through town hall meetings, online forums, personal health records and portals.
To learn more:
- find the report (.pdf)