The Role of Electronic Health Records in Chronic Disease Management for a Sustainable Health Care...

7/31/2019 The Role of Electronic Health Records in Chronic Disease Management for a Sustainable Health Care System

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Current concepts in healthcare system

Chronic disease burden is increasing globally

Population is aging

Disease epidemiology has been changing

Acute care centers

High-tech hospitals

Healthcare expenditures have to be limited

Patient-centered healthcare has to be at the center

New generation research (healthservices research, comparative

effectiveness research)

Need for high-value, cost-conscious care and a new generation of

so trained doctors

Value and quality based performance evaluation

THE NEEDIEST PATIENTS, THE BEST POSSIBLE CARE,

IN THE MOST COST-EFFECTIVE WAY


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Chronic disease burden

Integration of health systems and patient-centered healthcare models

are necessary to struggle with chronic diseases. Requirements are:

Wide social security coverage, quality indicators, quality based

performance evaluation

Strong information technology infrastructure with meaningful use

Strong leadership teams and cooperation among different sectors

Shared responsibility and accountability among leaders, healthcare

professionals and patients.

Well structured chronic disease management models (scientificguidelines, provider and patient education, feedback, and electronic

health records)


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Chronic disease management

Components of meaningful use of electronic health records

(EHR) and e-medicine:

The use of a certified EHR in a meaningful manner, such as e-prescribing,

The use of certified EHR technology for electronic exchange of

health information to improve quality of healthcare,

The use of certified EHR technology to submit clinical quality and

other measures.

Centers for Medicare & Medicaid Services. CMS EHR Meaningful Use Overview.


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Expectations from the EHR

Infrastructure

The participation of the patient - health literacy,

Integration of clinical guidelines decision

support systems,

Development of policies and programs for

managing chronic diseases,

National data for national surveillanceResearch

Finance models


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Quality indicators for the management

of hypertension

hypertension quality bundle

Number of patients over 18 years ofage who have had theirblood

pressure measured / all patients

Number of patients over 18 years of age whose blood pressure is


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Health databases in Turkey

Family Physicians Information System (Aile Hekimlii Bilgi Sistemi)

Primary care data

Health.Net (Salk.Net)

National EHR system

Periodically released and updated by the Ministry of Health

Secondary and tertiary care data

MEDULA

Used by the Social Security Institution to implement General HealthInsurance and to reimburse healthcare expenditure.

Reimbursement based data

TC Salk Bakanl ve Sosyal Gvenlik Kurumu


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Results: indicators in health

databases

Common for the three database age, visit date, drug use and period,

prescriptions

Family Physicians Information System and Health.Net bloodpressure for patients who are pregnant or diabetic

MEDULA blood pressure in chronic drug use forms for patients who are

diabetic

* The Ministry of Health released the new version of the national health data dictionary (USVS 2.0) in

March 2012 while the report was just about to be finalized. Blood pressure has a separate area as

a conditional (not obligatory) data to be entered in physical examination minimum health dataset.


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Conclusions and Suggestions for

Further Work

The first step in the war against chronic diseases is the country-wide

application ofpreventive medicine precautions.

Diagnosis of hypertension is the first step for being successful inhypertension management.

Recording blood pressure measurements has to be included within electronic

health records.

The development of a multi-dimensional and multi-sectoral research

agenda that rests on our national data systems will lead the way for

establishing effective prevention and control strategies for chronic diseases.


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Further Work

Without integrated health services, it is not possible to serve a highly

efficient and financially sustainable care.

Owning a national electronic health database that will serve as the basis

for a unified and quantitative performance system.

Utilizing surveillance data will have important contributions to our national

health and economy.

The infrastructure of the EHR systems, which are currently being used in

our country, can pave the way for an integrated health service and fora

performance measurement that focuses on quality and outcome.


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Further Work

The establishment of the infrastructure that will enable standard quality

service and the use of electronic health records infrastructure not only

for reimbursement, but also directly for patient care are at the core of a

high performance health system.

Meaningful use of electronic health records is only possible through

correctly entring the data, using standardized disease codes and using

this data directly for the diagnosis and the treatment of the patient.


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Further Work

The EHR systems infrastructure currently in use in our country can

lend itself well to the presentation of a unified health service and

a performance measurement that focus on quality and

outcome.

We strongly suggest that significant steps can be taken forward

towards the management of chronic diseases by modifying the

existing electronic health infrastructure and inspiring from the

acceleration supplied by the program of transforming health in

Turkey.


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Thank you

The Role of Electronic Health Records in Chronic Disease Management for a Sustainable Health Care...

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