The provided case study describes HealthPartners’ Medical Group’s transition to using electronic health records (EHR) and its impact on the organization’s compliance with HEDIS Controlling High Blood Pressure measure. The transition was completed in 2005, showing a significant increase in the measure. However, there were challenges associated with the development, as well. This essay will examine the case study’s background and assess HealthPartners’ transition to EHR.
Background
Over the course of implementing EHR, the HEDIS measures for controlling high blood pressure increased significantly. Specifically, patients who are 46-85 years old and have had an outpatient encounter with a case of essential hypertension are included in the measure. They are considered to have their blood pressure under control if its reading is at most 140/90. The HEDIS band, ultimately, is derived from the percentage of eligible patients with hypertension that have their blood pressure under control.
Over the seven years of the study, HealthPartners’ blood pressure measure and HEDIS band saw a significant improvement. 56.8% of the patients had their blood pressure under control in 2000, and by 2006, the number increased to 67.4% (Fowles et al., 2008, p.11). Consequently, the HEDIS National Band performance improved from 3 to 2 (Fowles et al., 2008). The percentage peaked at 75.4% in 2005 and subsequently fell to its latest value due to a change in HEDIS guidelines (Fowles et al., 2008). This peak suggests a higher potential improvement caused by the EHR system.
Initial implementations of EHR had issues with verification and required to be manually checked until errors in logic were uncovered. Furthermore, difficulties arose from a lack of familiarity with the system, necessitating more manual reviews. Nonetheless, transitioning EHR ultimately reduced the need for manual review of patient medical records, which reduced costs. Although the case study presents these issues as temporary and typical for a newly-implemented system, they still warrant examination.
Assessment
Two issues in implementation are apparent in the case study. One of those issues is technological, allowing for inconsistencies in the system’s logic. Although said inconsistencies were amended, it is not clear whether the underlying error was resolved, which is essential because “a lack of preventive or root-cause analysis will cause repeated failures” (Balgrosky, 2015, p. 206). A possible inference is that the processes involved in its implementation were insufficiently structured. Based on this inference, one can recommend that HealthPartners adopt an information technology governance (ITG) framework, or review their adherence to the chosen one.
The second issue in HealthPartners’ transfer fell within the sphere of leadership, as evidenced by the lack of familiarity. It is possible that the employees received insufficient training in the new database tools or were otherwise unprepared to use it. The study by Stevens, Mailes, Goad, Longhurst, & Pantaleoni (2015) stresses the importance of end-user training since failed or insufficient training can “result in patient safety, quality, and efficiency issues” (p. 87). Therefore, if a recommendation is to be made, HealthPartners should improve their teaching for the current system. In the future, they should ensure that implementations of HIT measures allow sufficient time for providers to be trained in the use of said measures.
Conclusion
HealthPartners’ case study demonstrates a significant improvement in the HEDIS Controlling High Blood Pressure Measures following their transition to an EHR system. Based on these improvements, one can conclude that HealthPartners’ initiative was a success. However, issues that arose in the project can be inferred to have been caused by poor end-user-training and lack of rigor in the technology of the implementation. Based on these inferences, recommendations can be made to improve those aspects.
References
Balgrosky, J. A. (2015). Essentials of Health Information Systems and Technology. Burlington, MA: Jones & Bartlett Learning.
Fowles, J. B., Kind, E. A., Awwad, S., Weiner, J. P., Chan, K. S., Coon, P., & Selna, M. (2008). Performance measures using electronic health records: five case studies. The Commonwealth Fund.
Stevens, L. A., Mailes, E. S., Goad, B. A., Longhurst, C. A., & Pantaleoni, J. L. (2015). Successful Physician Training Program for Large Scale EMR Implementation. Applied Clinical Informatics, 06(01), 80–95. Web.