Background on Dashboards
Quality dashboards provide organizations a snapshot of how they are doing on certain performance measures. The information then can be used by the organization to make improvements in care and sustain best practices. But, many dashboards don’t result in change of provider behavior. Some reasons may be: data presented is retrospective; it provides information only about the organization but not individual providers; and providers don’t see head to head comparisons with their peers. Currently, most quality dashboards are not available in a web-based format integrated within the electronic medical record (EMR), and therefore, do not leverage the technological advantages of using such a system. EMRs can be essential tools in applying quality improvement techniques in the practice of medicine.
Advantages of the web-based system
A web-based format addresses all these concerns by increasing the accessibility, portability and collaborative data gathering or reporting potential of a quality dashboard. Some important points to note include:
•Once the data leaves the reporting server (a computer that serves data to other computers) , it is posted directly onto the internet and accessible through a web portal. Therefore, the dashboard is available at home on a PC, on PDAs, smart phones or any mobile device that supports a browser.
•As long as the reporting server is functional, the crashing of a particular workstation won’t hinder access to the dashboard.
•The dashboard reports will be available in real time, allowing providers to make changes in care based on the feedback.
• Reports, drilled-down from other reports within the dashboard (ie. list of patient names with A1c <9% from number of patients with A1c <9%) could be generated on web pages opening up in different windows.
Additionally, if the dashboard was able to be pulled up within the electronic medical record being used, providers can see patient chart data along with dashboard results in order understand how treatment decisions affected dashboard results.
How is this advantageous to practicing clinicians or their office administrators?
•A web based quality dashboard offering advanced data displaying and reporting capabilities, would enable clinicians to make better decisions at the point of care.
•Also, administrators could be better equipped to work on their care processes by tracking these measures as drill-down reports from outcomes measures.
This could result in:
•Better quality of care leads to higher reimbursement, easier achievement of certifications from entities such as JCAHO, NCQA and greater patient satisfaction
•Increased reimbursement from meaningful use incentive money which requires six quality measures to be reported; NCQA which has a diabetes and patient centered medical home program and PQRI (physician’s quality reporting initiative), in which providers get reimbursed for reporting clinical information about their Medicare patient care panel.
•The formulation of a strong quality improvement program/process in your practice.
•Higher quality care and better patient satisfaction which will improve your practice’s reputation in the community
•Perhaps, most importantly, decreased errors which are financially and reputation wise very costly.
A link to a good dashboard as described in this article is found at http://projectpophealth.org/index.html.
Another organization that provides very useful dashboards in the field of psychiatry is Renci. The link is http://www.renci.org/focus-areas/biosciences-health/evidence-based-medicine
Conclusion: Web-based quality dasboards providing provider specific data and drill down reports is a new concept. It is true that such as system may be expensive or take lots of resources and is not for organization. However, as we head into healthcare reform and the push for higher quality care that is less expenseive (or at least cost-justified), such a tool could be the answer.
By Jitesh Chawla, MD.
