Key Elements: Transforming Care at the Point of Care

Transforming Care Principles

The goal of transforming healthcare is to help providers ensure that the care they deliver meets the six Institute of Medicine (IOM) aims- it is safe, effective, efficient, equitable, timely and patient-centered. The principles below outline the need for new models of care delivery, while the strategies and actions are grouped into three major strategic categories – moving providers to adopt health IT systems, supporting that adoption, and helping providers use health IT as a tool to enable transformation. It is important to note that while the first two strategic areas center on accelerating the adoption of health IT and supporting its use, this ultimate focus is on using health IT as a tool for quality improvement and care transformation – but health IT is not an end unto itself.

As with all areas of the Blueprint, this section should be considered in tandem with the other strategies and actions contained elsewhere in the Blueprint. For example, an important element of transforming care delivery into high quality patient-centric care is incentivizing activities such as care coordination, chronic care management, and enhanced preventive care. In addition, technology that is employed to support these functions must also protect the privacy and security of patient data.

The following recommendations are provided in the context of today’s reality, recognizing that as the actions in all areas of the Blueprint are implemented, some of theses strategies will necessarily and rightly change.

PRINCIPLES

1. Patient-Centered Care: Standards-based HIT and health information exchange (HIE) will support new models of care delivery that are patient-centered, for a lifetime, and physician-guided, reflecting a coordinated, collaborative approach. HIT and HIE will help providers and consumers improve the quality, safety, effectiveness, timeliness, efficiency and equity of care delivered across the U.S. healthcare system. In order for HIT and HIE to be truly patient-centered, the system should also provide meaningful, understandable and useful information for patients and providers at the point of care.
   
   
2. Patient and Clinician-Centered Workflow: The transformation to patient-centered care will be facilitated by making more complete, timely and relevant patient-focused data and clinical decision support tools available in a secure manner to both clinicians and patients as part of the workflow at the point of care. Information at the point of care through HIT and HIE will help integrate care across multiple care settings and facilitate team-based care.
   
   
3. Everyone Plays: All healthcare providers regardless of size, specialty, or location, and especially small physician practices (that deliver a majority of care in the U.S.) need to be engaged and supported in both local and national efforts to make patient-focused electronic health information available at the point of care. Furthermore, the acquisition strategy, support for workflow change, resources required to overcome implementation barriers, and ongoing maintenance of HIT and electronic healthcare information will differ.
   
   
4. Across Care Settings: There is value in adopting HIT in care settings, but greater value when the exchange of electronic health information is implemented across care settings. Care transformation will be supported by the deployment and use of HIT and secure data exchanges with all relevant stakeholders, including:
   
   

   Patients/Consumers Hospitals Emergency departments Laboratories and diagnostic centers Public health agencies Quality reporting and benchmarking organization

   Health plans Pharmacy benefit managers Physician practices Long term care facilities Home health agencies Pharmacies And other

   
   
5. HIT and HIE Are Enabling Tools: HIT and HIE are essential infrastructure elements that add value and efficiency for clinicians, other care providers and the patients they serve through information management and information sharing with each other and with other stakeholders in healthcare.
   
   
6. Overcoming Challenges: Selecting and implementing HIT and HIE tools, as well as the required process changes, are challenging endeavors. Overcoming these challenges to maximize effective use of HIT and HIE is critical to supporting, informing and improving care delivery at the point of care.
   
   
7. Reality - The Journey Begins Here: The transformation of US healthcare requires immediate attention but will happen over a period of years with multiple iterations at different paces across various care settings.