As good as some EHRs may be, they may only capture data for services that have been performed or information that’s been entered somewhere in the system. What about when there have been gaps in care, such as a medication reconciliation or a follow-up visit with a specialist that didn’t happen? What about data that should be there that’s simply missing because someone forgot to enter it or the event occurred outside the EHR?
It used to be that the number one concern about EHRs was their lack of interoperability—the ability to “talk” with other EHRs to integrate data from multiple sources, whether within a health system or across enterprises. Now, as the focus in healthcare shifts to value-based medicine, the conversation about EHRs has shifted to gaps in data. According to one recent survey, more than 4 in 5 primary care physicians (82%) and payer executives (88%) said that providers need access to more actionable insights from their EHRs to achieve value-based care. In this blog, we’ll talk about what some of those actionable insights could be—and introduce one possible solution that can help deliver them right to you.
Risk reporting is key
With the general population aging and people living longer, the number of patients with complex care needs is rising. Patients with multiple chronic conditions, for example, are responsible for 75% of typical primary care visits today.[i] It’s imperative, therefore, to have a patient’s risk for disease progression properly documented and to be able to flag any unaddressed risk factors. The need for comprehensive risk reporting is greater than ever.
The problem, however, is that claims data alone doesn’t adequately capture patient risk, and an EHR may be missing critical information to achieve accurate risk scoring. This has implications for patient care as well as practice health: inadequate or inaccurate risk coding can prevent medical practices from getting fully compensated for the care they deliver to high-risk Medicare Advantage patients. Accurate risk coding can be especially elusive because of gaps in risk scoring data.
Information gap identification
Second and perhaps even more important is looking for gaps in patient information, both to deliver high-quality care during and after the visit and help ensure accurate payments. These gaps may concern medications and prescriptions, active problem lists, missing evaluation and management (E/M) codes, or assessments from prior year claims, for example. With the average patient visit lasting about 18 minutes, and with the typical primary care visit addressing an average of 7.1 problems during that short time,[ii] pre-visit “gap analyses” can be critical to identifying information gaps in an electronic health record that can be addressed prior to or even during the patient’s visit.
One possible solution: Data Diagnostics®
Having comprehensive data is challenging even with today’s advanced EHRs—in a 2016 survey, nearly two-thirds of physicians said they don’t have all the healthcare information they need about their patients. And today’s practices simply don’t have time to track down missing patient data for each and every patient who walks through the door. Quest Diagnostics offers a solution. Data Diagnostics is an analytics tool that works within your EHR’s workflow to generate patient-specific reports that fill information gaps and help create more productive and comprehensive patient visits—visits whose actions get properly documented and reported to also help ensure proper compensation.
Ordered through an EHR just like a lab test,* Data Diagnostics creates three types of reports:
|Quality-Related Analytics: Provides a comprehensive picture of patients’ current or predicted clinical and quality gap status and actions needed to improve quality.
|Historical Data-Related Analytics: Provides insight into detailed medical history to aid in patient evaluation and diagnosis for more efficient and improved care.
|Risk Score-Related Analytics: Provides insight into patient risk score accuracy gaps (e.g., HCC, CRG, CDPS, etc.) and supports accurate disease burden documentation of unaddressed or worsening conditions.
*Results are delivered in real-time after an order is received by Quest; turnaround time can vary from system to system. Report information is based on data contained in existing datasets.
Data Diagnostics may help fill gaps in EHR data to make patient encounters more productive, clinical workflow more efficient, and financial performance goals more attainable. It makes your EHR work harder for you rather than the other way around. Learn more today.