The Agency for Healthcare Research and Quality’s “Telemedicine Safety Program: Improving the Diagnostic Process” is a free quality improvement program designed to help practices improve the cancer diagnostic process. It is led by NORC at the University of Chicago, Johns Hopkins University and Baylor College of Medicine.
Diagnosing cancer is a complex, multi-step process that takes place over time and often involves multiple specialties. Patients too often fall through the cracks, resulting in delayed or missed diagnosis. Telemedicine adds another layer of complexity and can serve as both a barrier and facilitator of the diagnostic process.
The program aims to improve the cancer diagnosis process in primary care settings with telemedicine by strengthening safety culture and helping practices close the loop on care transitions and other vulnerable processes along the diagnostic pathway of cancer
AHRQ aims to target key points along the diagnostic process where opportunities exist to reduce delays and improve care coordination.
As the program is currently recruiting for primary care practices, including OB/GYNs, and is scheduled to begin in June, Health informatics news sat down with two of his researchers to get a deeper look.
Dr. Hardeep Singh is the principal investigator. He is a professor of medicine at Baylor College of Medicine, a staff physician at the Michael E. DeBakey Department of Veterans Affairs Medical Center, and chief of the health policy, quality and informatics program at the Houston VA Center for Innovation in Quality, Effectiveness and Safety.
He codified VA’s national policy on communication of diagnostic test results, co-chaired the National Quality Forum’s committee on health information technology safety measurement recommendations, and developed ONC SAFER guidelines, providing national recommendations for the safe use of electronic health records.
Andrea Bradford is a co-investigator. She is a team scientist, licensed psychologist, and associate professor at Baylor College of Medicine. Its main interest is to develop programs and tools that address gaps in health services and the quality of health care.
In addition to her scientific roles, Bradford has more than a decade of experience as a clinical psychologist embedded in medical specialty settings. He has established two new integrated health psychology services at the University of Texas MD Anderson Cancer Center (2010-2016) and Baylor College of Medicine (2016-present).
Q. What is the status of the “AHRQ Safety Program for Telemedicine: Improving the Diagnostic Process.”
Singh: We are currently recruiting primary care, OB/GYN, community health and urgent care clinics for the program. Over 18 months, participants will gain practical knowledge and skills to address various vulnerabilities in the diagnostic process, including referrals, tracking abnormal test results, and managing diagnostic uncertainty.
Through a series of short, approximately 30-minute interactive webinars, physicians and practice staff will learn skills and strategies they can pilot in their practices. The program also includes supports for implementing these strategies, including one-on-one consultation with a quality improvement advisor and collaborative learning sessions with other participating practices.
Although the program is specific to cancer, many of the concepts are transferable to the diagnosis and care coordination of other diseases.
Q. What should CIOs, CMIOs and other health IT leaders in healthcare provider organizations know about this effort?
Bradford: This program will help practices close the loop at critical points in the diagnostic process by leveraging existing technologies and deploying IT in a way that maximizes impact in a hybrid environment, both telemedicine and in-person.
It is free to practice, involves doctors and staff and offers expert consultation. Most importantly, it can help improve patient safety and prevent harm.
Through the program, interns will also develop skills to learn from their own data. Capacity building and infrastructure for data collection, reporting, analysis and feedback will be supported. This data will help practices identify gaps in current processes that can be targeted for improvement and assess the impact of any changes.
The program does not require specific electronic health record platforms, configurations, or reports, will not collect any protected health information, and will not identify any individual patient, physician, practice, or health system.
Q. What should physicians involved in telemedicine know about this effort?
Singh: This is an exciting opportunity for physicians to expand their technical knowledge and improve quality of care and patient safety while earning Continuing Medical Education Units, Continuing Education Units, and Board Certification Maintenance Points American of Internal Medicine, as eligible.
Recognizing that hybrid care is now commonplace, this program will help physicians understand how to optimize the application of telemedicine during the diagnostic process.
We recognize that physicians have busy schedules and competing demands, so the program focuses on solutions that practices can easily implement and offers webinars and collaborative learning opportunities in a variety of formats and times.
Webinars are short (30 minutes) and will be available for viewing asynchronously. The team will only need to spend about two hours per month on the program, including attending webinars, reviewing program materials, and meeting with their practice team and quality improvement advisor. An additional hour per month will be allocated by a staff member to complete the data collection forms.
Another advantage of this program is that it can involve all types of practice personnel. Practice teams may include physicians, residents, and fellows; mid-level providers such as physician assistants and nurse practitioners; clinical support staff, including nurses and physician assistants; and, if available, planners and practice staff who carry out care coordination or navigation.
The program offers flexibility for staff to learn in a way that suits their schedules and preferred learning mode, offering live and recorded webinars, as well as online access to presentations, facilitator guides and tools and accompanying learning resources.
Our program staff is dedicated to helping practices succeed and will work closely with participating practices to resolve any issues should they arise.
Q. What would be the final achievement of this effort?
Bradford: We hope that participating practices will implement improved diagnostic processes that result in fewer patients with delayed or missed cancer diagnoses. Although the program focuses on cancer, the strategies learned in this program are transferable and can contribute to improving the diagnostic processes of other conditions as well.
Through webinars, training, and peer-to-peer collaborative learning, we anticipate that participants will learn best practices for closing the loop at critical points in the cancer diagnosis process in the telemedicine environment, be better prepared to serve a volume of growing patients instead of telemedicine and will emerge with skills. that improve patient safety, prevent harm and improve the quality of care delivery.
We are very excited about this program and recommend that practices consider joining. The application deadline is May 25, 2023. You can contact us at [email protected].
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Healthcare IT News is a publication of HIMSS Media.
The Agency for Healthcare Research and Quality (AHRQ) is currently looking for provider organizations to join their effort to improve hybrid telehealth solutions that combine digital and remote health services with traditional care. AHRQ, which forms part of the U.S. Department of Health and Human Services, is offering competitive grants to organizations with the goal of creating a robust, data-driven platform and technology infrastructure to optimize hybrid services.
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