Health IT alone won't improve quality, AHRQ report says

The application of health information technology in primary-care settings can improve the quality of care, but it's no magic wand for quality improvement, according to a report on two dozen grant programs funded by the Agency for Healthcare Research and Quality.

The report found the use of health IT coincided with greater adherence by providers to processes related to evidence-based care recommendations and improvements in patients' overall health status, as well as improved clinical outcomes for patients with chronic diseases if coupled with other workflow changes, among other findings.

The 31-page report, “Findings and Lessons from the Improving Quality Through Clinician Use of Health IT Grant Initiative” summarized the results of that IT grant initiative from AHRQ. It recounts the experiences of 24 projects funded by AHRQ from 2007-12.

Twenty-one of the projects took place in primary-care settings, such as physician offices, urgent-care centers, community health centers and federally qualified health centers, with the remaining three were in mental health and dental offices.

The online report has hypertext links to brief wrapups of the 24 projects, such as a quality improvement initiative at an internal medicine faculty practice at Northwestern University. Led by Dr. David Baker and colleagues, the research effort assessed the impact of computerized decision-support systems on clinical workflow and whether health IT use could improve performance on 18 quality measures for four chronic conditions and five preventive services. The Northwestern physicians found during the first year “performance improved significantly for 14 measures.”

Another, by the “Delta Health Alliance, Stoneville, Miss., looked at performance in four clinics in the Mississippi Delta—two rural and two urban, two with EHRs and two without. Overall results were “mixed,” but the “lessons learned were invaluable in demonstrating that installation of EHRs alone do not improve outcomes for chronic disease, but must include significant clinician training, support and usage of HIT tools, like clinical decision support.”

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