Neil N et al. 2003 "Improving rates of screening and prevention by leveraging existing information systems."
Reference
Neil N. Improving rates of screening and prevention by leveraging existing information systems. Jt Comm J Qual Patient Saf 2003;29(11):610-618.
Abstract
"BACKGROUND: In 1997 Virginia Mason Health System (VMMC), a vertically integrated hospital and multispecialty group practice, had no process or system to deliver the right patient clinical data, in the right form, at the right place--when providers needed it for effective patient care. Without any new investment in technology, a work group of five individuals leveraged existing, primarily paper-based information systems to launch development and implementation of a provider prompting tool--a ... report--which prompted providers to complete screening, prevention, and disease management services at every patient appointment. PLANNING AND IMPLEMENTING THE TOOL: The work group developed and pilot tested the report and created a mechanism by which the report could be delivered just in time before each patient's appointment. The report integrated information from independent appointment scheduling, laboratory results reporting, patient demographics, and billing data sources. MEASURING THE...REPORT'S IMPACT: The results of two separate analyses demonstrate improvement in rates of screening and prevention across VMMC soon after the...report became available. These results led senior leadership to make the...report's utilization a system wide imperative. DISCUSSION: The...report is used by nearly all primary care providers as a prompt to complete screening, prevention, and disease management services at every patient appointment."
Objective
To describe the "development and implementation of a provider prompting tool--a...report--which prompted providers to complete screening, prevention, and disease management services at every patient appointment."
Tools Used
Type Clinic
Primary care
Size
Large
Geography
Urban and suburban
Other Information
The study took place in the Virginia Mason Health System (VMMC); a multispecialty group practice of almost 400 physicians, located in Seattle with suburban clinics in the surrounding area.
Type of Health IT
Computerized clinical reminders (CRs) and alerts
Context or other IT in place
An information system that was "archaic, disintegrated and cumbersome," was already in place.
Workflow-Related Findings
"By the end of 2000, the ... report was being used daily by 12 primary care providers in two distinct geographic locations ... Provider opinions of the report were largely positive; in fact, the most vociferous complaints occurred whenever the program failed to run because participating providers had come to depend on the reports in their daily clinic rounds."
"By December 2001, approximately 83% of primary care providers were using the...report every day. By September 2002, 96% of primary care providers across VMMC were subscribing to the...report - a just-in-time, standardized, primary care and prevention summary for every clinic patient they saw."
"With the...report, a provider can tell at a glance that the next patient, who might be there for a sprained ankle, needs a mammogram or an LDL test. The report enables this minor revelation and corrective action hundreds of time per day around the medical center."
Study Design
Story
Study Participants
Primary care providers at Virginia Mason Health System participated.