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EHR Value for Population Health

A focus on the health of populations is essential to improving overall health status, economic productivity and the management of healthcare costs.  Diabetes is a good example of one chronic disease with  significant impact on the U.S. population and economy. 

According to the CDC

  • 29.1 million people in the U.S. have diabetes.  That’s one out of every eleven people.  
  • Another 86 million are pre-diabetic.  
  • In healthcare costs and lost wages and work, the cost of diabetes to the country is $245 billion each year.
  • Medical costs alone are twice as high for persons with diabetes as for those without the disease.  
  • Persons with diabetes are at much higher risk of early death, 50 percent higher according to the CDC.  
  • They are also much more likely to have serious complications such as blindness, kidney failure, heart disease, stroke and loss of toes or feet.

Diabetes is a population health problem of enormous proportions. Other chronic conditions also are part of the troubling and costly population health picture in the U.S.   

Until the implementation of EHRs, providers lacked the data to craft approaches to care that would address these health problems on a broad and targeted scale.  They needed to be better able to access data to initiate interventions that would focus on local and regional priorities.  With the EHR, that data is available.   Hospitals, health systems, physicians and other providers across the country are reporting measurable improvement results.  The HIMSS EHR Value Collection is brimming with examples of positive results that have been achieved over the past seven years.  A few examples tell the story:

  • Riverdale Family Practice in Bronx, NY, reported that the patient portal in their EHR offers reminders to patients to schedule follow-up care for diabetes. 
  • SSM Health Care in St. Louis, Mo. found with their EHR they experienced an 11% improvement in diabetes nephropathy (kidney disease) screening and a 15% improvement in diabetes blood pressure control.  In addition, they saw a 34% increase in tobacco cessation education and a 10% increase in the number of clinical nutrition consults.
  • St. Claire Hospital in Pittsburgh, Penn. achieved a pneumonia vaccination rate of nearly 100% of at-risk inpatients
  • At UCLA Health, the screening rate for pneumococcal immunization in hospitalized patients over age 65 increased by 90%
  • The University of Iowa Hospitals and Clinics reported that following the implementation of their EHR:
    • Adherence to pediatric immunization guidelines improved by 50%
    • Influenza immunizations increased by 76%
    • Pneumococcal vaccinations increased by 36%
    • Mammograms screenings increased by 18%
    • Colorectal cancer screenings increased by 39%
  • For Roane County Family Health Care in Spencer WV, the EHR assisted in controlling blood pressure in at least 70% of the clinic's patients.
  • For the Carolinas Healthcare System in Charlotte, NC, utilization of the EHRs asthma action plan tool rose from 80% to 98%.
  • The Southeast Minnesota Beacon Community has made significant progress for children.  Their pediatric asthma patients with an asthma action plan on file in school increased from 26% to 76% in two years.  In addition, 3,000 students have a documented asthma action plan on the shared portal.

These are only a few examples of the ways in which the EHR has supported the efforts of providers to improve the health of the populations they serve.  As reflected in the HIMSS EHR Value Collection, these types of results play out over and over across the country.  

The EHR is a core part of the infrastructure needed to support the work of provider organizations, clinicians, and caregivers everywhere to achieve their population health goals. 
 

Keywords: 
value of health IT; EHR; patient care; diabetes