Better Care. Improve the overall quality of the US health system by making health care more patient-centered, reliable, accessible, and safe. These goals, set forward by the Institute of Medicine in Crossing the Quality Chasm, are important domains for assessing the effectiveness of care improvements. In the context of the DSTI program, there is a focus on both the quality and experience of patient care. One area of increasing national attention has been a focus on improvement of care transitions between providers or settings of care. Health care transitions, such as moves in and out of hospitals to post-acute care/nursing home care, home care (with and without home care supports), or outpatient care have been shown to be prone to medical errors; poor care coordination, infections and incorrect usage of medications—leading to potentially avoidable hospital readmissions, less than optimal patient health outcomes, and added health care costs. This is especially the case for complex care needs, patients with social acuity, and co-occurring health conditions. Given the importance of examining patient care transitions and their effect on patient outcomes, three Common Measures, utilizing patient experience of care measures from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey focus on whether patients’ felt they had a good understanding of their medications and care needs post-discharge. Medication adherence and errors are a leading source of unnecessary emergency and acute care; therefore, it is an area of shared focus.94 Included within the HCAHPS measures is the Three-Item Care Transition Measure (CTM-3). This measure set has recently been added as a voluntary option to the HCAHPS survey.
Better Care. Quality, Safety & Safeguarding - To provide the highest quality, safest services, delivering the best outcomes
Better Care. Performance - Improve performance of the health and care system whilst seeking to meet the needs of our population.
Better Care. Facilitates patient care coordination amongst providers - Empowers patients to better manage their health - Reduces medical errors from not having full information - Access to life-saving information in an emergency - Improves public health tracking – Immunization reporting – ER admissions, discharges, transfers • -30% fewer admissions from the emergency department 1 • -56% reduction in patient readmissions within 30 days after hospital discharge 2 – Standards for exchanging information within “Health Homes” • Greater Efficiency/Lower Costs – Eliminates waste: duplicate or unnecessary tests, procedures and paperwork • -27% fewer repeat images within 90 days of first imaging procedure 3 • $52M in potential cost savings across NY State 1 Vest JR, Xxxx XX, Xxxxxxx Xx. TR, Xxxxxx MD, Kaushal R for the HITEC investigators. “Association Between Use of a Health Information Exchange System and Hospital Admissions”. 2 Vest JR, Xxxx XX, Xxxxxx MD, Kaushal R for the HITEC investigators. “Health Information Exchange and Hospital Readmissions”. 3 Vest JR, Xxxxxxx R, Xxxxxx MD, Xxxxxx K, Xxxx XX for the HITEC investigators. “Health Information Exchange and the Frequency of Repeat Medical Imaging.” 19 • The more records that are in the network, the more valuable the network becomes – Data can be used for patient care, care management, payers and public health uses • Potentially “blinded” data could be used for clinical research: – To understand origins of disease (genomics) – To monitor the safety of pharmaceutical drugs on the market • New “apps” can be built to help healthcare providers and patients use the SHIN-NY for specific needs • New York Leads the Nation Connecting Electronic Health Records – 72% of New York hospitals now participate in health information exchange – 5.1M patients have consented to share their health information electronically with their providers • Patient Record Look-Up • Direct Exchange of Records between Providers • RHIOs in NYS – community-based organizations – funded through the HEAL grants and community support – under contract with NY State • NY State administered HEAL grants – establishes legal and policy framework for compliance with Statewide Policy Guidance • As HEAL grants sunset, new “mechanism” now needed to assure – uniform practices across RHIOs – adherence to Statewide Collaborative Process and Governance – full establishment of the Statewide Health Information Network of NY (SHIN-NY) – Ensure public trust • Review with Program/...
