Health IT

The Power of the Scale

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When was the last time you stepped on a scale?

Many of us completely avoid it. Stepping on the scale means facing the reality of the number that appears in black and white. It is easier to live with an estimate of our weight or a belief that we are within a few pounds of our goal weight.

The scale is an objective assessment and is often the spark that motivates change. The delta between our goal weight and actual weight might be frightening, but the numbers often incent us to make some changes if we can muster the courage to step on the scale.

Let’s shift our focus away from personal goals to organizational goals. When is the last time you put your electronic health record (EHR) adoption efforts on a scale? Do you objectively measure the progress in key areas?

Dr. Farzad Mostashari, MD, national coordinator for Health Information Technology, U.S. Department of Health and Human Services, recently asked these questions of the healthcare leaders attending our Healthcare Forum, a gathering of influential healthcare IT leaders, in Washington D.C.

How would we know if adoption of EHRs was improving quality of care? How would we know if computerized physician order entry (CPOE) decreases medication errors?

First, we must have the courage to step on the scale and face the reality of our baseline metrics. Next, we must set goals and take action to improve our performance.  Today, many of us believe we are within a few pounds of our goals, but the experience of organizations that have stepped on the scale suggests we aren’t even close.

Dr. Jen Brull, CEO of Prairie Star Family Practice in Plainville, Kan., took the stage immediately after Dr. Mostashari challenged us to step on the scale. Her practice implemented an EHR more than five years ago, and the practice has made impressive progress in adopting the system. In fact, Dr. Brull was the first physician in Kansas to attest to Stage 1 Meaningful Use.

Dr. Brull’s presentation focused on the value of an EHR to improving clinical care.  She revealed baseline data for several preventative screenings that would frighten most clinicians – only 65 percent of patients had been screened for breast cancer, and 43 percent for colorectal cancer.

When initially presented with that data, Dr. Brull’s reaction was that it was surely wrong, incorrect, or flawed in some way. She is a physician who takes great care of her patients, understands the importance of preventative care and has a passion for quality improvement.

However, the numbers were accurate and reflected the reality of the many challenges healthcare providers and organizations face today. These baseline metrics got her attention. In less than two years, both screening rates were above 90 percent because of efforts focused on process improvement.

She had the courage to step on the scale, and it made all the difference.

Metrics allow us to gauge our progress. They provide objective assessments of our performance. We must have the courage to step on the scale and make the changes necessary to improve clinical outcomes. EHR systems won’t improve care on their own, we must commit to the changes required to improve the safety and quality of care.

Step on the scale – it could make all difference.

Heather A. Haugen, PhD., is the corporate vice president of research at The Breakaway Group, a Xerox Company.