The New York City Health & Hospitals Corp.s more than decadelong investment in information technology has boosted access, improved quality and curbed errors, according to a report by the Commonwealth Fund.
Based in Manhattan, the sprawling public systems clinicians have successfully used electronic health records, computerized physician-order entry and a wired pharmacy to improve care for asthma, depression and diabetes; reduce hospital readmissions and medication errors; and tackle costly, preventable conditions such as bed sores and certain infections, the authors said.
The sprawling systems success has helped it compete for limited public financing as a safety net provider to a highly diverse and vulnerable population, the report said. The nearly 40-year-old system is the nations largest to be city-owned and handles one-third of New Yorks emergency room visits and one-sixth of the citys inpatient care, the report noted. One out of three patients treated by the 11-hospital public system, which also operates more than 80 community clinics and six diagnostic and treatment centers, lack insurance.
Health & Hospitals Corp. President and Chief Executive Officer Alan Aviles cited the systems standard EHR as central to its success. Prompts embedded in EHRs have helped curb hospital-acquired infections in intensive-care units; improved heart attack and heart failure treatment; and contributed to a 50% decline in bed sores at its hospitals, the report said.
Aviles said the greatest challenge for further success will be upgrading its EHR to one that is compatible across the system and able to communicate with outside providers and payers.
One vendor supplied Health & Hospitals Corp.s existing EHR, but staggered adoption across several years left the systems regional networks with incompatible platforms. To overcome the communication barrier, officials created a data warehouse that pools medical records from its disparate platforms to allow a systemwide analysis of quality and safety measures, Aviles said. Armed with the information, clinicians can track performance and patients health. And executives can set and monitor strategic clinical initiatives, he said.
Funding sources for its anticipated upgrade have become increasingly uncertain as the U.S. economy weakens and turmoil in the financial sector undermines New Yorks economy, he said. In the past 10 years, Health & Hospitals Corp. has poured $100 million into expanding healthcare IT across its operations in the citys five boroughs, largely financed by federal grants, Aviles said.
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