Improving Health for Populations and Communities

Better Primary Prevention and Diagnosis

Electronic health records (EHRs) give clinicians a powerful tool for preventing errors, measuring performance, and sharing information with patients and other providers. As more clinicians adopt EHRs and make them part of the patient care process, they also are relying on them to coordinate individual care and manage population health.

The Quality Improvement Organization (QIO) Program is an ally in this effort. From August 2011 through July 2014, office practices are encouraged to take advantage of QIO assistance with clinical data reporting and to join in local improvement initiatives that leverage EHR functionality to increase rates of preventive services and decrease cardiac risk factors.

A Major Force for Improvement

QIOs in every state and territory, united in a network administered by the Centers for Medicare & Medicaid Services (CMS), have the flexibility to respond to local needs. At the same time, they offer providers the opportunity to contribute to broader health quality goals, such as those set by the U.S. Department of Health & Human Services' National Quality Strategy and its Action Plan for Reducing Health Care-Associated Infections. IPRO is the QIO for New York State.

Current QIO Program initiatives are aligned with other major health quality improvement programs and can help ambulatory practices improve their ability to report clinical quality data from their EHR systems and prepare for value-based payment by Medicare and other insurers.

New Ways to Work Together

The latest in improvement science, including new models for accelerating and spreading change, has shaped the QIO Program's approach. This means providers have more and different ways to be a part of QIO initiatives. QIOs are functioning differently, too. Rather than limiting their role to technical assistance, they are convening statewide learning and action networks (LANs) that recognize everyone has knowledge that can contribute to better care. By participating in a LAN, health care providers can harness the power of a community for addressing common challenges, connect with a peer facility for mentoring, and replicate best practices in their own facility.

Harnessing Health IT for Better Care

Current QIO Program initiatives for improving population and community health through effective use of health information technology include:

Increasing rates of preventive screenings.

Effective use of health information technology increases the capacity of primary care clinicians to deliver preventive services. Building on the success of their previous EHR initiatives, QIOs are working with primary care practices that want to take full advantage of their EHR's functionality for supporting care coordination to increase rates of screening mammograms, colorectal screenings, and influenza and pneumonia vaccinations. Participating practices can increase the number of patients for whom they have complete preventive care data, identify patients who need preventive care, measure and improve preventive care performance, and report data to CMS.

Reducing cardiac risk factors.

The QIO Program is a partner in the Million Hearts campaign, a joint initiative of CMS, the American Heart Association, and other national health care stakeholders that aims to improve America's heart health. Million Hearts seeks to reduce cardiac risk factors that include hypertension, smoking and high cholesterol and increase heart-healthy behaviors, such as aspirin for those who need it. Through their QIO, clinicians and patients can link to resources for care coordination and patient self- management. QIOs also will support practices in using their EHRs to coordinate care and measure improvement in the health of patients who are most at risk for a heart attack.

Supporting more and better clinical quality data.

Until recently, practices that wanted to participate in the CMS Physician Quality Reporting System (PQRS) had to submit claims or registry data. Now practices can report these data directly from their EHR systems. Local QIOs are providing technical assistance to accurately capture the required data elements and extract them for reporting. Data submission qualifies practices for incentive payments over and above their usual annual Medicare reimbursement. The data, which are also incorporated into CMS' Physician Compare website (available at medicare.gov), offer consumers information to help them make decisions when selecting providers.

Connecting EHRs to quality improvement.

QIOs are coordinating with health IT regional extension centers (RECs) in their state or territory to offer improvement expertise to practices that have implemented an EHR but not yet attained meaningful use. This may include, for example, offering assistance in interpreting clinical performance data and using it to drive and measure change. QIOs also are encouraging participation in CMS' EHR incentive programs.

Learn More and Become Involved

IPRO invites all providers, community stakeholders, beneficiaries and caregivers to become partners in its new improvement initiatives. Contact us at ambcare@ipro.org or 1(800) 671-1841.

Additional information on the CMS Medicare and Medicaid EHR Incentive Program is available at www.cms.gov/EHRIncentivePrograms.

Information on the regional extension centers (RECs) in New York is available at:

• New York eHealth Collaborative (NYeC) www.nyehealth.org (outside of New York City)
• NYC Regional Electronic Adoption Center for Health (REACH) www.nycreach.org (within the five boroughs of NYC)

For more information about IPRO's activities supporting physicians in using their electronic health record systems please visit www.ehr.ipro.org.