Dr. Bonner Uses Health IT and Clinical Decision Support to Improve Patient Engagement
Dr. Hugh Bonner III is a family practice physician at Saint Francis Hospital, a community hospital in Wilmington, Delaware. He is Associate Program Director for the hospital’s Family Medicine Residency program, which consists of five faculty members and eighteen residents. Dr. Bonner and his team serve an inner city population consisting of a majority of Medicare and Medicaid patients. To improve patient care, Dr. Bonner and his colleagues developed their electronic health record (EHR) system to incorporate best practice guidelines. These include the Million Hearts guidelines, which focus on prevention of heart attacks and strokes, and the U.S. Preventive Services Task Force (USPSTF) guidelines, which focus on preventive care for all ages. These and other guidelines, including recommendations from the American Diabetes Association (ADA) for diabetes care and The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) for hypertension care help Dr. Bonner and his colleagues create an atmosphere that fosters best patient care practices.
Using Health IT to Improve Patient Engagement
After going live on the EHR system in July 2010, Dr. Bonner and his colleagues realized it was critical to learn how they could take advantage of the many tools available in the system. They knew learning the ins and outs of the EHR system would be critical to Saint Francis’s success. “All staff attended regular classes conducted by Quality Insights of Delaware, our local Regional Extension Center, to better understand our EHR system and its functionalities,” Dr. Bonner recalled.
As Dr. Bonner and his colleagues became more familiar with the EHR system, they understood the potential of EHRs to improve patient engagement and health care quality. “We knew there were best care practices we could incorporate into our EHR system to better address the unique needs of our patient population,” Dr. Bonner stated. Working with Quality Insights of Delaware and their EHR vendor, Dr. Bonner and his colleagues built Million Hearts guidelines into their EHR system software. Now, when one of Saint Francis’s providers enters a diagnosis related to heart disease or stroke, the EHR system’s clinical decision support rules automatically bring up Million Hearts recommendations.
With the Million Hearts guidelines on the computer screen, Dr. Bonner and his colleagues are better equipped to educate their patients and can quickly show patients how their health data compares to Million Hearts guidelines for blood pressure, cholesterol, and smoking status. Dr. Bonner and his colleagues now use their computers and EHRs as interactive tools to bring patients into the care delivery process as active participants in their care. For example, Dr. Bonner has learned that the computer monitor can be positioned at a 45-degree angle so patients can easily view the screen and see their measures in real time along with their provider. “This process engages patients as active participants so they learn and understand more about their health and health care,” Dr. Bonner explained. “This is something we could not do in the paper world.”
Best Practices for Quality Improvement
With guidelines such as the Million Hearts, JNC 7, USPSTF, and ADA guidelines, all of which focus on key diseases prevalent in Saint Francis’s patient population (e.g., hypertension, heart disease, stroke, and diabetes), Dr. Bonner and his colleagues can improve health care quality. “We have the health care quality improvement data we need at our fingertips,” explained Dr. Bonner.
In addition to continuing to improve health care quality by using best practice guidelines and clinical decision support, Saint Francis is taking what Dr. Bonner describes as a “huge step forward” and is implementing a patient portal. For Dr. Bonner and his colleagues, the patient portal will serve as another valuable tool to improve patient engagement with Health IT.