Urban Health Plan harnesses tech for quality improvement

Technology has been a cornerstone to the growth of Urban Health Plan (UHP), which serves patients in the Bronx and Queens of New York City, according to a case study from the College of Healthcare Information Management Executives (CHIME).

It's an economically challenged area. Nearly 50 percent of families live on less than $25,000 a year, according to the 2000 Census.

HIMSS honored the community health center network in 2009 for its EHR implementation, and UHP sites are recognized National Committee for Quality Assurance (NCQA) as Level 3 Patient Centered Medical Homes.

Now, its IT infrastructure will be vital under reform as care continuity and coordination become increasingly important to the organization's bottom line.

It's implementing data warehousing and analytics to not just gather information, but to gain perspective from it. The bulk of its quality-improvement data comes directly from its electronic health record system.

"At the end of the day, it comes down to performance improvement," UHP Chief Technology Officer Daniel Figueras said. "The underlying theory is that if we don't have oversight on all the things required to run the organization, then we're not doing our jobs. Gathering information and then feeding it back to clinicians is one of the key pieces we do here."

For example, it found that patients were not likely to come back for tests or follow ups. Now it now offers at least 17 types of specialty care and handoffs between primary and specialist visits are facilitated by the use of the EHR system. It has created a culture of reporting; its more than 120 physicians' performance is evaluated monthly on quality metrics.

It also uses iris-scanning technology to match patients to their records, and for more than a year has used software software that helps identify the correct ICD-9 and ICD-10 codes.

Stressing the need to be preparing for the future, UHP is looking ahead to when telemedicine will be used more widely in providing care and connecting patients to specialists in other settings.

Key lessons, according to the study, include the need  for a clinician in a key implementation role¸ the importance of training and the need to demonstrate technology's clinical benefits.

New Jersey-based primary-care practice Vanguard Medical Group also touts the benefits of technology, which it has used to create a risk stratification matrix within its EHR and as part of its patient engagement efforts.

What's more, the crux of a recent article in Medscape Business of Medicine on becoming a patient-centered medical home is that many organizations likely are following PCMH-worthy the best practices, just not documenting them. It's just a matter of capturing that data.

To learn more:
- find the case study (.pdf)

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