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How Can Clinical Quality Officers Change Doctors’ Behaviors?

Clinical quality officers have a tough job. They have to change the behavior of people providing care in their health systems. This means doing everything they can to remove the barriers that keep healthcare professionals from providing the best care possible.

Many quality officers are tasked with things completely out of their reach—reducing mistakes that happen during patient visits, lower hospital readmissions, and ultimately allowing their organizations to control the cost of care.

To the frustration of quality officers and many in the medical community, there is no guarantee that proven best practices will get adopted by doctors in a meaningful time frame, or if at all. Dr. Atul Gawande aptly observed this struggle in the history of medicine in his New Yorker piece, ‘Slow Ideas.’ “Here we are in the first part of the twenty-first century, and we’re still trying to figure out how to get ideas from the first part of the twentieth century to take root.”

CDS as a Solution
As the quality leaders look to technology to deliver trusted best practices to physicians in a timely manner, Clinical Decision Support (CDS) solutions have emerged that offer evidence-based guidelines that are digitized, sortable, and easy to access and navigate. CDS solutions minimize risks of medical errors, reduce diagnosis errors—which can account for 10-30% of medical errors. They can do this by giving all caregivers consistent and credible information and improve efficiency through reducing unnecessary patient expenditures. They can also offer an updated, single source of truth for clinical best-practice information.

CDS offerings have brought a great deal of value to physicians and patients, however they still struggle to be adopted. With limited time, busy physicians often find CDS alerts distracting and lacking full context. The most commonly used decision support aid provides only reference articles based on patient’s diagnosis, which forces the physician to spend time reading one or more articles. The challenge for the next wave of innovators will be to get CDS built into the physician’s workflow and offer a deep analysis of the patient data that has been absent to date.

CDS Hold the Potential to Improved the Clinician’s Relationship with the EHR
Though unpopular, electronic health records (EHRs) are a necessary evil that could offer an informed CDS output, integrating relevant patient historical and encounter data. The happy marriage of CDS and EHR information could form a powerful union. It would equip physicians with complex, patient-specific, decision making as part of their patient-visit workflow, delivering just the behavior change quality officers need.

According to the head of the American Medical Association (AMA), enhancing the ability for EHRs to improve clinical care is vital. “Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus,” AMA President-Elect Steven J. Stack, MD, said in a news release.

The Next Generation of CDS
If CDS accessed patient data to help provide evidence-based recommendations at the point-of-care, they could truly improve both quality of care and outcomes. EHRs could be profoundly improved if they offered CDS that:

* Pulls patient data from EHRs to make real-time, patient-specific recommendations triggered by the physician at the point-of-care
* Can make complex calculations and decisions with specific patient data and the latest evidence-based guidelines
* Saves physicians time searching through thousands of new medical research articles and guidelines published monthly
* Offers a more focused visit, allowing physicians to get the specific patient recommendation they need quickly

Such capabilities would allow quality officers to incorporate patient-specific care recommendation based on evidence-based best practices directly into the physicians’ workflow.

When we consider how quality can be improved — bringing all the best practices of our time to a physician at the point of care with patient context — the EHR has the potential to truly improve the quality of patient care and outcomes. Such solutions would equip quality officers to enable the behavior change they need to control quality.