Healthcare Information Technology Research & Analysis : Coplan & Company : IT Procurement Management, Project Management, System Acquisition

The University of Michigan's Department of Family Medicine developed ClinfoTracker (now commercially available from Cielo MedSolutions as Cielo Clinic) to provide preventive and disease management services at the point of care. Richard Pizzi summarized the study in HIT News on September 5, 2008.

Although ClinfoTracker is not an EHR it performs some functions that are surprisingly similar.  For example, the September 2008 issue of the Medical Journal of the American Public Health Association reported that the University of Michigan Health System (UMHS) completed a study using ClinfoTracker.  The study concluded that ClinfoTracker Best Practice Alerts (BPAs), such as annual pap smears, flu vaccines and blood sugar testing for diabetics, improve health outcomes. The need for a third party product like ClinfoTracker is an example of how healthcare fails to properly use an EHR and unnecessarily increases cost and complexity of HIT.

Don’t good EHRs include BPAs, call lists, reminders and reports on clinical reminder response rates?  I know of several EHRs that don’t require these types of third party add-ons.  For example, on June 11, 2008, the 2007 HIMSS Public Health Davies Award recipient, Neil Calman, MD, President and CEO
of the Institute for Family Health, described how their EHR notifies providers if patients meeting certain criteria should receive specific treatment.  For example, in 2006 new findings indicated women taking ACE (Angiotensin-Converting Enzyme) inhibitors during their first trimester of pregnancy had a high risk of serious cardiac and other birth defects.  The Institute immediately ran an EHR database report and notified all childbearing age women prescribed ACE inhibitors about this new information. The Institute contacted 220 women about avoiding the potential risk of delivering a child with serious birth defects by changing their medication regimen.

Good EHRs include functions like electronic flow sheets to track patients' clinical problems and BPAs for preventive care over time.  The need for third party HIT, like ClinfoTracker to augment an EHR, just underscores that users often fail to properly define their needs and acquire an EHR that does not support them, or they are not fully utilizing their EHR.

A properly managed successful HIT project for an EHR includes thoroughly:

• Planning the project,
• Defining user needs,
• Acquiring a solution meeting these needs,
• Implementing the system successfully and
• Performing ongoing system and user support.