Vision for value-based care must include clinical decision support integrated into EHR

Healthcare recognizes the role that evidence-based medicine plays in improving outcomes and lowering costs. The use of clinical decision support tools incorporating evidence-based medicine at the point of care provides physicians with access to translational research and current recommendations.

Kaiser Permanente recently completed a large-scale, electronic health record-based integration of clinical decision support tools including access to predictive analytics, a prescription formulary, treatment algorithms and evidence-based disability guidelines.

“Integrating evidence-based decision tools at Kaiser involved planning and multiple stages of implementation,” said Kurt Hegmann, MD, director of the Rocky Mountain Center for Occupational and Environmental Health at the University of Utah and a Kaiser partner. “Engagement with all stakeholders including physicians, IT and administrators was essential for success. All implementation steps were important to be able to improve value and the quality of healthcare.”

The road to real, meaningful evidence-based medicine is a long and iterative process that requires vision from the CEO level, identification of useful and real evidence-based medicine tools and not mere lookalikes, implementation, problem-solving, and continuous improvement, Hegmann added.

To peers working in evidence-based medicine and clinical decision support, Hegmann offers hard-won advice.

“Have a vision and plan for developing value-based care that includes evidence-based medicine tools adoption, implementation, and continuous quality improvement,” he said. “And expect to have to adjust the plan while not losing focus.

Overall, there is a nascent trend toward value-based care that arose from prior quality improvement efforts. IT tools are providing the means to achieve what previously was challenging on paper

“The day where reimbursement is largely or totally value-driven based on insurer/business/CMS-based requirements is likely quite near, and being unprepared for these changes could be organizationally fatal yet proactively avoidable,” Hegmann said.

Hegmann will be speaking in the session, “Integrating evidence-based decision tools within an EHR,” at 8:30 a.m March 8 in the Venetian, Murano 3304.