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Improving Chronic Illness Care with an EHR

An electronic health record (EHR) is a tool.  One of your goals for this major investment is improved patient care.  If you chose the correct product you will now have more information about your clinical practice than you have ever had with paper charts. You can obtain baseline data through reports specifying subgroups for intervention, such as patients with a specific diagnosis, patients receiving certain medications, patients with test results out of range, or patients due for preventive services.

It is the responsibility of management to spend a large portion of time in planning improvement projects that include the use of the EHR system.  Calculating the return on your investment includes improved efficiency and a better patient experience.  This should also include ensuring the right care for every patient at the right time, even those patients who have not been seen recently.  The use of the EHR system lends itself well to the disease management process.

Steps for improvement activities using an EHR are the same as for any improvement activities.

1. Identify the clinical care area for improvement and gather baseline data (report generated from EHR).
2. Identify all possible barriers, bottlenecks, and breakdowns in providing the necessary care.
3. Consider possible changes that will make it easier to provide the identified care and reach your desired outcome.
4. Conduct a small test of the change idea (i.e., with one patient, one provider) and decide if the change is better.  Remember that not all changes are an improvement and fixing one problem may unintentionally create several more problems.
5. Modify the change idea if necessary and retest on a small scale.  After refining the change idea, move forward with spreading the change within your practice to achieve optimal clinical care for all your patients.
6. Continue to monitor available data to ensure implementation of the change becomes part of the clinical care within the practice.

More detailed information on care management with an EHR is available through the Care Management Module found at DOQ-IT University.  See “Setting Up Your Practice for Care Management.”