Clinical Documentation

Treatment Inertia   Treatment, or clinical inertia is well documented in the medical literature.  Practice administrations struggle with methods for

Two Washington, D.C. clinics, Chartered Family Health Center (CFHC) and George Washington Medical Faculty Associates (GWMFA), have begun using an innovative mobile solution to manage their diabetic patients. Both pilot programs are utilizing DiabetesManager software from Baltimore, Md.-based chronic disease technology solution provider WellDoc. DiabetesManager captures, stores, and transmits in real-time the blood glucose data and other diabetes self-management information via a patient’s mobile device.

As we look at retrospective data and fashion a story to explain it, it's extremely important to realize that most humans, including doctor-doctors (MD, PhDs, as well as executives with and without advanced degrees in every field) are highly prone to these fallacies. The narrative fallacy, the attempt to view data as linear (or Gaussian, with predictably low risks of falling outside of prior experience) (see " Fooled by Randomness"). Or the fallacy of failing to recognize the sampling and cognitive biases that financial incentives routinely cause for the best of us. Healthcare rarely follows relatively simple laws of physics like the law of gravity.

C-suite executives in virtually all U.S. hospitals would agree that improving care delivery while simultaneously cutting healthcare costs are the twin goals of every clinical information and documentation solution initiative. Following a 2006 report by The Institute of Medicine (IOM) that concluded there is “a national crisis in emergency care,” we have seen a large number of hospitals make IT investments for their hospital emergency department (ED).

The Charlotte, N.C.-based Premier healthcare alliance has been one of the leading organizations pushing the envelope on quality-based purchasing in the healthcare field for several years. Indeed, Premier healthcare alliance’s core program in this area, the CMS/Premier Hospital Quality Incentive Demonstration (HQID) program, which was launched collaboratively by Premier and the federal Centers for Medicare and Medicaid Services (CMS) in October 2003, has seen more than six years of impressive results, including an overall improvement in measured patient care quality of an average of 17.2 percent over the first four years of the HQID demonstration project, and an estimated 4,700 heart attack patients’ lives saved in the program’s first four years, according to Premier estimates. Meanwhile, a sister initiative, Premier’s QUEST: High Performing Hospitals initiative, has already racked up estimates of 8,043 lives and $577 million saved, as of last October, through that program’s focus on the elimination of avoidable hospital mortalities and on cost savings, across 157 participant organizations.