“It is not necessary to change. Survival is not mandatory.” —W. Edwards Deming
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Explore This IssueFebruary 2017
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For practices to survive, change is a requirement—not an option—in the rapidly evolving practice of rheumatology care.
Pharmaceutical therapies are advancing quickly, opening the door for game-changing therapies in the treatment of chronic autoimmune disorders. With these advances comes a need for increased focus on patient safety, a message also being reinforced as new payment models reward coordinated patient care and quality patient outcomes.
To support this emphasis on quality and safety, daily practices in rheumatology clinics are being rewired to improve coordinated care, standardize processes and minimize care gaps in practice. Although these are lofty goals for some, these are areas of hard-fought progress for others. Many rheumatology clinicians are well on their way in the process to rework the necessary pieces into practice to advance patient-centered care, leverage electronic tools (without creating extra work) and optimize clinician time to focus on what matters.
For example, with the Rheum-PACER system in place at Geisinger Health System in Danville, Pa., information is aggregated from the electronic health record (EHR), the nurse, the provider and the patient, who answers a touchscreen questionnaire at the beginning of a clinic visit. This information is displayed in real time and supports care coordination among all members of the rheumatology team.
The Web-based system serves two important goals. The first is to catch care gaps in data (missing patient information) and quality (care that needs to happen) to effectively trigger timely reactions in the care process. The second is to drive care processes that become proactive, so patients and clinicians can spend their time working toward new goals in treatment, explains Eric Newman, MD, who works in the Department of Rheumatology at and is vice chair for clinical innovations in the Division of Medicine at Geisinger.
Research led by Dr. Newman on the effectiveness of the Rheum-PACER system showed significant improvements in care quality and efficiency, and a 26% increase in productivity.1 Dr. Newman says the Rheum-PACER software is just one example of hardwired safety in practice that is positively affecting patients. He notes that they are always improving the system, because providing best-in-class care through continuous process improvement is a journey, not a destination.
Start with a Strong Safety Culture
No matter where you and your practice colleagues are in this process, the key is to keep moving forward. But none of it will work if an openness to improvement through team collaboration and individual ownership is not a deeply engrained goal for all, Dr. Newman explains, adding that the remnants of an historic “feudal” healthcare culture in which the physician leads and support staff follow is the No. 1 reason implementing and sustaining a successful safety program fail.