Quality health care is doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results. Patient safety practices protect patients from preventable harm associated with health care services. Together, care quality and patient safety improvement activities can help the health care team achieve the six aims described in the National Academy of Medicine’s (formerly the Institute of Medicine) Crossing the Quality Chasm: safe, effective, patient-centered, timely, efficient, and equitable care.
Electronic health records (EHRs) facilitate improvements in health care quality and safety compared to paper records. EHRs enable clinicians – as well as patients, and their proxies - to have access to relevant information about the patient as well as integrated best practice support in the form of electronic Clinical Decision Support (CDS). CDS provides persons involved in care with general and person-specific information, intelligently filtered and organized, at appropriate times, to help improve care outcomes by making the information needed to support sound decisions available when it is most useful to the care team.
When implemented and used correctly, EHRs provide more legible documentation that can more easily follow the patient from one point of care to another and drive EHR functionalities that improve care. EHR functionalities such as electronic prescribing and automated support for drug-drug and drug-allergy interaction checking are welcome advancements for patient safety.
EHRs also play a role in improving population health by supporting trend and outlier analysis in large amounts of aggregate health data, allowing clinicians and public health professionals to take action within their scopes of practice to improve outcomes. These population health activities are becoming increasingly important as we look to improve our nation’s health. As new care models evolve focusing on both population and patient outcomes, EHRs make meeting quality reporting program requirements more efficient for clinicians by increasingly automating the harvest of performance measurement information from data routinely captured in the course of care. Clinical quality measures that are specified in standard format for automatable, interoperable electronic reporting from the EHR are referred to as electronic clinical quality measures (eCQMs).
Like all powerful tools, EHRs carry risks with their use. However, unintended consequences can be minimized by following best practices for the design, implementation, user training, and use of EHRs. Planning is needed to get the most out of your EHR investment and to ensure its safe use. The resources provided throughout this Playbook provide clinicians with a place to start making fuller use of EHRs to improve care quality and safety.