Earlier this year, the CDC, as a part of their Morbidity and Mortality Weekly Report, published an article entitled: Using Electronic Clinical Quality Measure Reporting for Public Health Surveillance. The article begins by giving us some positive statistics on the increasing use of EHRs and the data from those EHRs being helpful to population health initiatives. It specifically focuses on “clinical performance goals of Million Hearts, a U.S. Department of Health and Human Services initiative that was launched in 2012 to prevent 1 million heart attacks and strokes by 2017.” The power of focusing on just a few Clinical Quality Measures (Blood pressure, aspirin, and Cholesterol measures) associated with such a clear goal showed positive trends in a steadily increasing number of providers providing these CQMs based on this incentive.
As with every study, the article laid out the limitations of this particular study, which focused on blood pressure only, before getting into the detailed results of their work. The seven limitations they named were quite typical, including possible duplicate data and possible non-reporting of improved patients, but the limitation that seemed most unnecessary and raised my blood pressure indeed was, “Sixth, incentive program CQM reporting was based only on the data available in the EHR system of the health care provider. If a patient transitioned to another provider, such as a specialist, the original EHR might not have subsequent, possibly improved, blood pressure values recorded.”
The fact is, those specialists very likely did or could have reported those results back to the primary care physician, but it would most likely arrive as a fax. So, the information is there and even possible attached to the patients record in the EHR, but no one can access it for this study.
Why is that? Healthcare information stuck in unstructured formats, such as faxes, are overwhelming in volume. Handling the documents themselves, just for the sake of reviewing and filing put enough strain on organizations. If you add manual data entry to that, it becomes very difficult.
Well, imagine if your fax line could feed directly to a software application on your computer. This software could process any documents with clinical information which could then automatically be presented to you for review with at least 80% of the desired clinical data captured into discrete fields 100% correctly. In essence, replacing data entry with a simple review, thereby speeding up the process of getting the data into your EHR and reducing data entry errors. Imagine that in the time it would take you to acclimate yourself to that document and simply find the order date, you could have reviewed all the data in a structured format that would have everything where you expect it to be for easier review. When you finished your review, the data would automatically populate the discrete fields of you EHR and you would be presented with the next document to review. Imagine.
