Online Program

280317
Improving patient health outcomes through an EHR based quality improvement initiative: A multimedia program description and provider perspective of bridges to excellence (BTE) as a tool for minimizing health disparities in chronic condition management


Monday, November 4, 2013

Meital Fried-Almog, MPH, Division of Health Care Access and Improvement, Primary Care Information Project (PCIP), New York City Department of Health and Mental Hygiene, Long Island City, NY
Alison Chaikittirattana, MPH, Division of Health Care Access and Improvement, Primary Care Information Project (PCIP), New York City Department of Health and Mental Hygiene, Long Island City, NY
Marcin Dzialo, RN, BSN, Division of Health Care Access and Improvement, Primary Care Information Project (PCIP), CUNY Hunter-Bellevue School of Nursing at Hunter College, Long Island City, NY
Jennifer M. Celio, MS, OTR/L, Division of Health Care Access and Improvement, Primary Care Information Project, CUNY School of Public Health at Hunter College, Long Island City, NY
Christine Stroebel, MPH, Division of Health Care Access and Improvement, Primary Care Information Project (PCIP), New York City Deparment of Health and Mental Hygiene, Long Island City, NY
Elizabeth Wolff, MD, MPA, Division of Health Care Access and Improvement, Primary Care Information Project (PCIP), New York City Department of Health and Mental Hygiene, Long Island City, NY
Background: Since its inception in 2005, the New York City Department of Health and Mental Hygiene's (DOHMH) Primary Care Information Project (PCIP) is committed to improving the quality of care in medically underserved communities through the successful adoption and use of health information technology and data exchange. In alignment with PCIP's unique partnership with primary care providers serving high risk patient populations, PCIP has joined efforts with the New York State Health Foundation's (NYSHF) Meeting the Mark (MTM) initiative, which aims to assist 3,000 primary care providers statewide achieve recognition for excellence in diabetes care. PCIP has assisted 51 providers achieve recognition through the Bridges to Excellence (BTE) Diabetes Recognition Program, providing an opportunity for clinicians to assess their documentation and workflow practices in hopes of improving overall diabetes care. Objective/Purpose: To describe PCIP's BTE project in a descriptive, qualitative format using providers' insights in a multimedia presentation, in which the project's recruitment, implementation and recognition challenges and successes will also be highlighted. Methods: Recognition status is based on a thorough review of the providers' charts, and the assessment of 7 clinical measures related to excellence in diabetes care. Regardless of whether recognition is achieved, providers are then given individual feedback that is meant to enhance patient outcomes through revised workflows and improved documentation practices. Results: Out of 74 participating providers whose charts were assessed, 69% of providers, who serve approximately 68,000 patients, achieved recognition. Discussion/Conclusion: By participating in BTE, providers received feedback concerning the quality and thoroughness of care they administer to their patients with diabetes, and gained awareness on areas in need of improvement. High-performing providers receptive to receiving feedback on the clinical measures assessed were also more inclined to implement changes in their documentation and workflow practices, and therefore more likely to achieve recognition.

Learning Areas:

Administer health education strategies, interventions and programs
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify how quality improvement initiatives like BTE help to assess providers' gaps in care through EHR utilization; define how the EHR may be used meaningfully so that the disparities in the management of chronic conditions, such as diabetes mellitus, are addressed;describe BTE and list its program objectives;list at least 3 of the clinical measures that are based on the American Diabetes Association’s recommendations; identify 2 challenges that occurred during the recruitment and implementation stages of the project, and identify how providers overcame workflow and documentation challenges in order to better serve their patients and achieve recognition.

Keyword(s): Diabetes, Computer-Assisted

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a Program Specialist at PCIP, I have managed the Bridges to Excellence (BTE) Diabetes Recognition Program, which includes recruiting providers, conducting chart reviews, and providing feedback post-assessment. The project culminated in a multimedia presentation featuring providers’ perspectives, shown during a bureau-wide meeting. Among my research interests are chronic disease management through the utilization of Health IT and the role the built environment plays in the health of urban women.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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