Sustaining Provider Engagement in EHR-based Projects

Medicare now pays for more preventive services than ever; however, few beneficiaries are taking full advantage of them. QIOs are helping primary care physicians (PCPs) leverage Electronic Health Record (EHR) systems to increase the number of Medicare beneficiaries who receive potentially life- saving preventive services. With recruitment completed and participating practices in place, the key challenge ahead for QIOs is sustaining these practices’ engagement.

Hurdles at this stage are varied and plentiful: primary care practices generally have limited time and resources, and physicians and staff are bombarded with information from multiple sources. Practices participating in the CMS Prevention Theme benefit from QIO consultation. They learn how to:

• Modify clinical workflows to achieve greater efficiency;
• Fully utilize EHRs to coordinate patient care; and
• Extract and report data from their EHR system to support quality improvement.

Two QIOs, Quality Partners of Rhode Island and Quality Insights of Pennsylvania, are among those that have shared best practices and lessons learned for maintaining provider engagement.

Quality Partners’ approach is based on a Practice Assistance Plan that includes a practice assessment tool to determine current practice workflows. The tool identifies how EHRs are used and with what frequency, the type of workflows in place and the nature of the reporting, tracking and outreach for specific preventive care measures. Quality Partners customizes the assistance plan for each practice, conducts educational sessions featuring a physician champion speaker, offers EHR vendor demonstration sessions, and maintains monthly communication with each practice’s designated point of contact.

“One of the biggest lessons learned for our team is to ‘reinforce, reinforce, reinforce training and education’ of participating physician practices to ensure long-term success,” said Maureen Claflin, R.N., M.S.N., senior director of quality improvement at Quality Partners. “With the proper technical assistance, practices are realized that they can have more complete patient records and time-saving workflows, be better prepared for the Physician Quality Reporting Initiative and become more quality to receive the American Recovery and Reinvestment Act’s meaningful use incentives.”

Quality Insights’ approach incorporates a number of educational opportunities to improve provider engagement. For example, QIO staff helped standardize orders, labels and placement of documents, and developed guidelines for consistent provider data entry. Embracing a “share-and-learn” technique, Quality Insights offers user group meetings, partners with “super users” within practices and creates regional physician collaboratives.

Both QIOs are actively collaborating with EHR vendors to customize reports and helping practices increase the accuracy and frequency of data capture. Other best practices include sharing benchmark data to encourage healthy competition among practices, and employing various educational and training tactics for practice staff so they can experience improved clinical workflow efficiencies firsthand.