Health IT as a catalyst for transformation: For want of a nail
by Holly Miller, MD, MBA, FHIMSS
July 1, 2014
Clinicians matter. Workflow matters. Data matters. Technology is ultimately just a catalyst for health care transformation. Dedicated providers and their teams are required to create advanced primary care practices, patient-centered medical homes and neighborhoods.
A study recently published in the Annals of Internal Medicine confirms this. Researchers looking at practices in New York’s Hudson Valley found that primary care physicians participating in medical homes improved their quality of care over time--and at a significantly higher rate than their non-PCMH peers, regardless of whether the non-PCMH practice used paper or electronic health records.
EHR technology proved insufficient to achieve improvements in care. It was the combination of EHR use plus organizational changes that was associated with the greatest quality improvement. These results strongly suggest that changes to organizational culture and workflow, as well as how practices implement technology are essential to improving quality of care.
MedAllies was involved in this study. Via local partnerships and the Hudson Valley Initiative, MedAllies helped hundreds of physicians--including those in the study--implement EHRs and become patient-centered medical homes. Because of our experience here in the Hudson Valley, we understand how to activate clinical interoperability across communities and across disparate EHR systems. We help providers and their care teams define role-based clinical workflow utilization of their EHR tools to maximize their opportunities to capture and use data to assist their transformation efforts.
So when it comes to implementing Direct in support of achieving a patient-centered medical neighborhood and meeting the Meaningful Use Stage 2 requirements, we are prepared. MedAllies has developed an onboarding process that enhances existing clinical workflow and fosters seamless transitions of care. It’s that mindset of clinical and technical expertise that we bring to Direct -- it’s at the heart of MedAllies Direct Solutions™.
MedAllies Direct Solutions provides a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted personal health information directly to known, trusted recipients via the Internet--an approach that works across EHR vendors.
The MedAllies approach enhances and optimizes the practices’ EHR workflows to process and integrate information exchanged during patient transitions of care. A clinician has pertinent clinical information “pushed” into her EHR system, allowing her to provide the highest quality, safest and most efficient care possible.
MedAllies operates a leading national Direct network, but our implementation focus is clinically and community centered. MedAllies Direct Solutions builds on existing EHR-based workflows. We engage directly with the clinical staff to incorporate Direct exchange of information into each practice’s regular stream of work. Through our proven three-phase, three-track onboarding process, while the technical team is working on integration and testing activities, we ensure clinicians receive the implementation materials and guidance they need to “go live” in 30 days. We have successfully used this same process with tens of thousands of providers across the country.
Technology is a catalyst. It provides a means to our goal: transitions of care that foster care coordination in service of the three-part aim of better care, improved health and reduced costs. If we don’t make this goal a reality, the technology is just a hammer without a nail.
 Kern LM, Edwards A, Kaushal R. “The Patient-Centered Medical Home, Electronic Health Records, and Quality of Care.” Ann Intern Med. 2014;160:741-749.