TY - JOUR
T1 - Information technology to support improved care for chronic illness
AU - Young, Alexander S.
AU - Chaney, Edmund
AU - Shoai, Rebecca
AU - Bonner, Laura
AU - Cohen, Amy N.
AU - Doebbeling, Brad
AU - Dorr, David
AU - Goldstein, Mary K.
AU - Kerr, Eve
AU - Nichol, Paul
AU - Perrin, Ruth
N1 - Funding Information:
This manuscript presents results from “Creating Health Informatics Applications for Collaborative Care” (CHIACC), a project to increase consensus regarding informatics technologies that support improvement in chronic illness care. Primary funding for CHIACC was provided by the Department of Veterans Affairs (VA). The VA operates the largest integrated health care system in the United States—a system with a comprehensive, fully computerized EMR.18,25,26 The goals of CHIACC were to understand how informatics can support improvement in the quality of care and to inform next steps in software development for organizations that have moved or are moving from paper-based to electronic records.
Funding Information:
available for this article at doi:10.1007/s11606-007-0303-4. This work was supported by the Department of Veterans Affairs through the Health Services Research and Development Service QUERI, (MHS-03-218) and the Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), and by the NIMH UCLA-RAND Center for Research on Quality in Managed Care (MH 068639). Any opinions expressed in this manuscript are the authors’ and do not necessarily represent the views of the Department of Veterans Affairs.
PY - 2007/12
Y1 - 2007/12
N2 - BACKGROUND: In populations with chronic illness, outcomes improve with the use of care models that integrate clinical information, evidence-based treatments, and proactive management of care. Health information technology is believed to be critical for efficient implementation of these chronic care models. Health care organizations have implemented information technologies, such as electronic medical records, to varying degrees. However, considerable uncertainty remains regarding the relative impact of specific informatics technologies on chronic illness care. OBJECTIVE: To summarize knowledge and increase expert consensus regarding informatics components that support improvement in chronic illness care. Design: A systematic review of the literature was performed. "Use case" models were then developed, based on the literature review, and guidance from clinicians and national quality improvement projects. A national expert panel process was conducted to increase consensus regarding information system components that can be used to improve chronic illness care. RESULTS: The expert panel agreed that informatics should be patient-centered, focused on improving outcomes, and provide support for illness self-management. They concurred that outcomes should be routinely assessed, provided to clinicians during the clinical encounter, and used for population-based care management. It was recommended that interactive, sequential, disorder-specific treatment pathways be implemented to quickly provide clinicians with patient clinical status, treatment history, and decision support. CONCLUSIONS: Specific informatics strategies have the potential to improve care for chronic illness. Software to implement these strategies should be developed, and rigorously evaluated within the context of organizational efforts to improve care.
AB - BACKGROUND: In populations with chronic illness, outcomes improve with the use of care models that integrate clinical information, evidence-based treatments, and proactive management of care. Health information technology is believed to be critical for efficient implementation of these chronic care models. Health care organizations have implemented information technologies, such as electronic medical records, to varying degrees. However, considerable uncertainty remains regarding the relative impact of specific informatics technologies on chronic illness care. OBJECTIVE: To summarize knowledge and increase expert consensus regarding informatics components that support improvement in chronic illness care. Design: A systematic review of the literature was performed. "Use case" models were then developed, based on the literature review, and guidance from clinicians and national quality improvement projects. A national expert panel process was conducted to increase consensus regarding information system components that can be used to improve chronic illness care. RESULTS: The expert panel agreed that informatics should be patient-centered, focused on improving outcomes, and provide support for illness self-management. They concurred that outcomes should be routinely assessed, provided to clinicians during the clinical encounter, and used for population-based care management. It was recommended that interactive, sequential, disorder-specific treatment pathways be implemented to quickly provide clinicians with patient clinical status, treatment history, and decision support. CONCLUSIONS: Specific informatics strategies have the potential to improve care for chronic illness. Software to implement these strategies should be developed, and rigorously evaluated within the context of organizational efforts to improve care.
KW - Chronic disease
KW - Clinical information systems
KW - Decision making
KW - Informatics
KW - Quality improvement
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U2 - 10.1007/s11606-007-0303-4
DO - 10.1007/s11606-007-0303-4
M3 - Article
C2 - 18026812
AN - SCOPUS:36448946526
SN - 0884-8734
VL - 22
SP - 425
EP - 430
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - SUPPL. 3
ER -