Tips for generating and utilizing quality data reports using health it full slide deck

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Tips for generating and utilizing quality data reports using health it full slide deck

  1. 1. U.S. Department of Health and Human ServicesHealth Resources and Services Administration HRSA Health Information Technology and Quality Webinar “Tips for Generating and Utilizing Quality Data Reports Using Health IT” Date: 7/22/2011 US Department of Health and Human Services Health Resources and Services Administration
  2. 2. Office of Health Information Technology and Quality Additional HRSA Health IT and Quality Toolboxes and Resources including past webinars can be found at: http://www.hrsa.gov/healthit http://www.hrsa.gov/qualityAdditional questions can sent to the following e-mail address: HealthIT@hrsa.gov • US Department of Health and Human Services • Health Resources and Services Administration
  3. 3. Upcoming HRSA Health IT and Quality Announcements• New Items to the HRSA Health IT Site: • CMS Frequently Asked Questions Document on Meaningful Use for CAHs • HRSA Health IT Adoption Toolbox for HIV/AIDS Providers• Next HRSA HIT and Quality webinar, "Privacy and Security – What Questions Should You Ask Your Vendor“ Friday August 19th 2pm EST• Last month’s webinar “Tips for the Safety Net Community on Using Health IT within a Patient Centered Medical Home” Now available online• HRSA “Call for Papers: Evidence for Informing the Next Generation of Quality Improvement Initiatives: Models, Methods, Measures and Outcomes” for Journal of Health Care for the Poor and Underserved. Due September 1st. Questions? Please contact OHITQPapers@hrsa.gov
  4. 4. IntroductionPresenters:• Margaret Flinter-Community Health Center Inc.• Dr. Kwame Kitson-Institute for Family Health• Bob Demarco-Springfield Medical Care Systems Inc.
  5. 5. Using Data to Drive QualityDaren Anderson, MD - VP/Chief Quality OfficerNwando Olayiwola, MD, MPH - Chief Medical OfficerMargaret Flinter, APRN, PhD - Senior VP/Clinical DirectorCommunity Health Center, Inc.July 22, 2011 1
  6. 6. Community Health Center, Inc.Our Vision: Since 1972, Community Health Center, Inc. has been building aworld-class primary health care system committed to caring for underserved anduninsured populations and focused on improving health outcomes, as well asbuilding healthy communities. CHC Inc. Profile: • Founding Year - 1972 • No. of health centers – 12 • No. of Service Locations - 173 • SBHC locations – 23 • Organization Size - 450Innovations• Integrated primary care disciplines• eConsults with specialists Three Foundational Pillars• Fully integrated EHR• Patient portal and HIE Clinical Excellence• Automated clinical dashboards Research & Development• Nation’s first Nurse Practitioner Training the Next Generation residency training program
  7. 7. CHC Inc. Patient Profile • Patients who consider CHC their health care home: 130,000 • Health care visits: 350,000 per year CHC Patient Demographics 90.80%100%75% 64.8% 65% Patient Care Model 42%50% 22% • PCMH (NCQA Level 3)25% 6% 0% • Advanced access scheduling • Clinical dashboard & drive improvement • Expanded hours Care Delivery • Clinical integration of all services Medical Care & Ancillary Services • Formal research program Dental Care • Electronic health records Mental Health Care • Residency training for nurse practitioners Prenatal • W.Y.A. (Wherever You Are) Health Care for the Top Chronic Diseases homeless Cardiovascular Disease • Mobile dentistry services to 150 schools Diabetes • Outreach and eligibility screening/enrollment Asthma
  8. 8. Performance Feedback – Competing Interests Organizations Providers Productivity & Efficiency Quality and Performance Population Health Individual patient outcomes Systems improvement Professional Growth10/05/10 4
  9. 9. Middle Ground? • Providers are inherently interested in and concerned about the quality of care they deliver • Self-reflection is a powerful driver • Framing of QI feedback – non-competing interests • Utilize multiple vehicles to communicate performance10/05/10 5
  10. 10. Provider-Centered QI Cycle • Encourage provider participation in measure Defining selection and definition • Provide frequent, individual and systems Enhancing Monitoring reporting • Provide actionable data to front line teams • Link performance and Reporting quality10/05/10 6
  11. 11. Multilevel Performance Assessment Performance Appraisals Peer Reviews Data Driven Provider Feedback Dashboard and Professional Education Sharepoint10/05/10 7
  12. 12. Using Data to drive QI • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 8
  13. 13. Key Points • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 9
  14. 14. CHC Quality Improvement on SharePoint10/05/10 10
  15. 15. 10/05/10 11
  16. 16. 10/05/10 12
  17. 17. 10/05/10 13
  18. 18. 10/05/10 14
  19. 19. Key Points • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 15
  20. 20. Based on “Clinical Microsystems”, Nelson et al10/05/10 16
  21. 21. Key Points • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 17
  22. 22. Embed Measurement into each PDSA • How will we know that a change is an improvement? • Use Survey Monkey, EHR data, chart reviews, hand counts, to measure PDSA outcomes • Data collection does not need to be complicated. Simplicity is key10/05/10 18
  23. 23. Based on “Clinical Microsystems”, Nelson et al8/19/10 19
  24. 24. 10/05/10 20
  25. 25. • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 21
  26. 26. Example: Planned Care Huddles• Purpose: – ensure all patients are offered routine prevention/screening – improve efficiency – share routine tasks amongst the team – promote team cohesion – improve the health of our patients and our community
  27. 27. Basic Process• Pre-huddle – MA reviews CDSS for scheduled visits next day – MA notes things that are due on a paper copy of the schedule – RN reviews patient schedule for vaccine needs/SM needs/other disease management needs• Huddle – booked into schedule each day – MA convenes huddle 5 minutes before start of patient schedule – Brief review by team of what is due, discussion of plan for complex cases.
  28. 28. Missed Opportunities: Agency-wide 595 595600500 424400 A1C testing in patients with diabetes (6months) 303 Breast cancer screening 290300 Colorectal cancer screening by colonoscopy 219200 Depression Screening 148 146 115100 39 32 24 0 Week of April 25th Week of May 2nd Week of May 9th
  29. 29. Missed Opportunities: Site that started huddling40 3635 Sum of A1C30 testing in patients with diabetes (6 months)25 Sum of Breast 24 cancer screening 22 2120 17 17 Sum of Colorectal15 cancer screening by colonoscopy10 10 Sum of 9 Depression 7 Screening 6 5 4 4 3 3 2 0 0 4/25 5/2 5/9 5/16 Middletown
  30. 30. Missed Opportunities: Site that didn’t start huddling200180 179160 Sum of A1C testing in patients with140 142 diabetes (6 138 136 months) Sum of Breast120 cancer screening100 Sum of Colorectal80 80 cancer screening by colonoscopy 65 65 6560 Sum of Depression40 Screening 35 32 3220 24 11 11 6 4 0 4/25 5/2 5/9 5/16 Meriden
  31. 31. 10/05/10 28
  32. 32. 10/05/10 29
  33. 33. • Key Points for discussion: – Make data easily accessible to teams – Use a structured QI approach – QI projects need a strong focus on measurement – Collect data to evaluate each PDSA – Provide actionable data to front line teams – Use data to drive performance and sustain gains10/05/10 30
  34. 34. Improving HTN Care Using Technology Developing an HTN Dashboard – Combine registry reporting from EHR with real-time pt data from the practice management system – Present timely, actionable data to each care team – Not just a performance “report card”8/19/10 31
  35. 35. Hypertension Performance Indicators 32
  36. 36. Locate your panel on Share point
  37. 37. Click to sort by Average BP or Next Appt
  38. 38. Summary of Key Points • Performance feedback critical for provider professional growth and clinical objectives • Framing of QI feedback for providers must reflect balance between quality and efficiency, not competition • SharePoint is an effective tool for providing easily accessible data to front line teams • Use multiple sources of data to evaluate QI projects • Present actionable data • Data drives performance10/05/10 36
  39. 39. Comments or Questions? Please Contact: Daren Anderson VP/ Chief Quality Officer Daren@chc1.com 860.347.6971 ext.3740 _________________________ Margaret Flinter Senior VP and Clinical Director Margaret@chc1.com 860.347.6971 ext. 3622 _________________________ Nwando Olayiwola Chief Medical Officer Nwando@chc1.com 860-347-6971 ext. 3728 37
  40. 40. Medical Home Coordinated Care Management Start date: 05 05 11Springfield Medical Care Systems Springfield, Vermont
  41. 41. Springfield Medical Care System Brief Chronological Organizational HistorySpringfield Hospital was formed in 1914 • Moved to our current location in1923; expansions 1955,1964 • Critical Access Hospital designation received in 2005 – 9 primary care practices, 1 OB/GYN practice, 5 specialty practices – FQHC approval received in 2009 • Unique model, perhaps the only one in the United States where a community health center and critical access hospital work together under one umbrella governing Board of Directors.
  42. 42. Our Service Area• We serve 12 communities in Vermont and New Hampshire• Service area population is approximately 35,000
  43. 43. Long standing relationship Primary Care – Springfield HospitalLong history of close working relationship betweenprimary care practices and hospital presenting uniqueopportunities to assess our environment, identifyrealizable goals, collaborate and implement changetowards establishing a Medical Home for the communitywe serve.
  44. 44. An opportunity recognizedEstablish a care coordination system between ourCommunity Health Center and Hospital.Initial Focus: Emergency Department Utilization
  45. 45. Emergency Department Emergency Department Volume18,000 1 7 ,3 3 5 1 6 ,8 2 6 1 6 ,8 7 6 1 7 ,0 2 5 1 6 ,1 3 516,000 1 5 ,6 2 4 1 4 ,3 9 814,000 1 3 ,0 1 6 1 2 ,7 4 2 1 2 ,5 6 8 1 2 ,6 4 1 1 2 ,1 9 912,000 1 0 ,6 4 310,000 8,000 6,000 4,000 2,000 0 FY 1998 FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010
  46. 46. Key Daily Indicator Report 05 01 11 - 06 11 11 05 01 11 - 07 09 11 Definitions Summary Average / Total Average / Total Definitions define "Indicator" and identifies number as average or total Community Health Center - Monday through Friday Indicator No./% No./% Indicator Definition New patients 143 218 Total new patients added daily Indicator of system growth CHC Utilization 88% 90% Average percentage of clinicians blocked hours filled Indicator of clinical activity and capacity Walk ins/same day 1833 3133 Total number of walk in patients accepted Indicator of clinical activity and capacity No shows 444 781 Total number of patients did not show for appointment Indicator of clinical activity Springfield Hospital Indicator No./% No./% Indicator Definition Emergency Department, Inpatient Activity - Sunday through Saturday; OR Utilization - Monday through Thursday; Endo - Monday through Friday Emergency Department visits 46 47 Average number of ED patients daily Indicator of ED activity level Admissions 193 338 Total number of inpatient admissions daily Indicator of clinical activity level Discharges 208 354 Total number of inpatient discharges daily Indicator of clinical activity level * (Actual) OR Utilization (Room 1) 85.6% 72.6% Percentage of OR capacity utilized Indicator of clinical activity level * (Actual) OR Utilization (Room 2) 78.3% 60.6% Percentage of OR capacity utilized Indicator of clinical activity level * (Actual) Endoscopy Utilization 66.6% 65.7% Percentage of Endoscopy capacity utilized Indicator of clinical activity level Transfers 27 40 Total number of ED transfers for no capacity Indicator of restricted capacity Midnight Hospital census 18.5 19.0 Average number of inpatients at midnight, end of prior day Indicator of final daily census Observation patients 1.0 0.9 Average number of observation patients at midnight Indicator of clinical activity level 9a.m. Activity Report - Daily planning meeting "snapshot" - Monday through Friday Core Measures (met/not met) Met 100% Met 100% Clinical hospital quality measures (met or unmet) Quality of care indicator 9 a.m. Hospital census 18.7 19.3 Average number of inpatient and observations patients Indicator of daily census 9 a.m. Windham Center census 9.1 9.0 Average number of patients Indicator of daily census Labor 0.4 0.3 Average number of labor patients (not in census) Indicator of clinical activity level One to one patient care 0.4 0.5 Average number of patients with special needs Indicator of clinical activity level Same Day Surgery admissions 0.9 0.8 Average confirmed ED and Same day surgery admits Indicator of ED activity level Confirmed ED admissions 0.3 0.4 Average number of available total staffed beds Prime capacity indicator Total inpatient capacity 21.7 20.4 Average number of available total staffed beds Prime capacity indicator* Note: (Actual) OR/Endo Utilization collection data start date June 6
  47. 47. Emergency Department General categories of visits• Emergent care• Acute care chronic disease management: – heart failure, diabetes, asthma, pain management, pneumonia, mental health• Unable to get an appointment with PCP• Practice closed to new patients• Patient has no designated PCP• Patients with financial needs,10% of ED patients are insured• Frequent Flier• Drug Seekers• Transient
  48. 48. An Opportunity for a Medical Home Capture and redirect from ED to CHC• Emergent• Acute care chronic disease management: – heart failure, diabetes, asthma, pain management, pneumonia, mental health• Unable to get a timely appointment with primary care physician• Practice closed to new patients• Patient has no designated PCP• Patients with financial needs,10% of ED patients are insured• Frequent flier• Drug seekers• Transients
  49. 49. Capture audience• We have assessed that 2000 to 3500 Emergency Department ED patients annually through a coordinated systems based effort might be redirected to our Community Health Center and provided a Medical Home – This respresents12 to 20% of our current ED volume
  50. 50. Impact of ED volume reduction AssumptionsEmergency Department Community Health Center– Improved access to – Increased utilization Emergency Services for – Increased Medical Home those that need it population base– Shorter ED wait times – Increased opportunities for– Increase in clinical value preventive care time – Appropriate management– Reduction of potential of chronic disease medical errors – Less costly delivery of care– Lower staff burn out
  51. 51. Medical Home Coordinated Care ManagementHospital Care Managers CHC Care ManagersBuilding a system to coordinate communications andfollow up between our established hospital CaseManagement system and our newly formed CHC CareManagement Team
  52. 52. Indicators for CHC care coordination & CHC referral• ED patients without identified CHC primary care provider• ED patients requiring post ED procedure follow up care• ED “frequent fliers”• Patients with a chronic diseases: CHF, Diabetes, Obesity, Pediatric Asthma• Patients seen in the ED within 3 days of a CHC visit• Patients requiring financial assistance, 10% of ED patients are uninsured.
  53. 53. Key measurable improvement indicators • Volume of new CHC patients • Volume of walk in/same day CHC patients • CHC Utilization • Volume of ED visits, i.e. volume reduction – Volume of ED patients assigned a PCP – Volume of frequent fliers – Volume of chronic disease referrals – Volume of patients provided financial assistance • In addition this team will be coordinating inpatient hospital discharges and hospital readmissions
  54. 54. Initial Goals• Increase CHC Utilization by 7% – Improve access – Increase walk-in/same day – Increase Community education• Decrease ED volume by 15% – Assign PCP – Chronic Disease referral, increase management – Financial Assistance – Decrease frequent fliers
  55. 55. Very early progress indicators At this point, a bit of the Hawthorne effect, perhaps• CHC Walk in Same Day Access - 17% increase over 2010• ED patients assigned a CHC PCP – 14 patients per week are being identified as needing a PCP• ED Volume is demonstrating downward trend towards 2007-8 levels – Economy, other factors vs early care coordination efforts
  56. 56. Summary• Our overall goal is provide excellent preventative primary care• Data will guide us to determine the sources of patients who will benefit and measure progress• A Care Management system that joins our CHC and hospital has been implemented and is in the beginning stages of evolution• Early data results points towards potential wins• Next steps will move to include our local community care centers as part of our care management network
  57. 57. THE IMPACT OF HEALTH INFORMATION TECHNOLOGY ON QUALITY IMPROVEMENT THE INSTITUTE FOR FAMILY HEALTHKwame A. Kitson, MDVP of Quality ImprovementInstitute for Family Health19 West 21st streetNew York, NY 10003kkitson@ institute2000.org212-633-0815www. institute2000.org HRSA Webinar July 22, 2011
  58. 58. LEARNING OBJECTIVES NOW THAT YOUR ORGANIZATION HAS ACCESS TO DATA, HOW DO YOU TRANSLATE THAT INTO MEANINGFUL USE ? HOW CAN THE USE OF DATA AND REPORTING IMPACT PATIENT SAFETY ? HOW CAN THE USE OF DATA AND REPORTING IMPROVE QUALITY MEASURES PERFORMANCE ?
  59. 59. MEANINGFUL USE OF HIT DATA “MORE DATA = MORE PROBLEMS”
  60. 60. MEANINGFUL USE OF HIT DATA A mountainful of data yet a finite amount of resources to handle it.
  61. 61. MEANINGFUL USE OF HIT DATA “Beware lest you lose the substance by grasping at the shadow .” Aesop Solution- Target measures and target resources in the most efficient ways possible.
  62. 62. MEANINGFUL USE OF HIT DATA Electronic Patient Outreach Team Created
  63. 63. PATIENT SAFETY DRUG RECALLS
  64. 64. THE IFH RESPONSE TO THE VIOXX RECALL FDA SENDS AN ALERT BY EMAIL INTERNAL VIOXX REPORT GENERATED 664 PATIENTS IDENTIFIED VIA REPORTINGWITHIN 35 MINUTES OF RECEIVING FDA EMAIL ALL BUT SIX PATIENTS CONTACTED BY TELEPHONE OR MAIL WITHIN 10 DAYS
  65. 65. PATIENT SAFETY DRUG INTERACTIONS AND CONTRAINDICATIONS INTERNAL EHR VENDOR LINKED DRUG- DRUG INTERACTION WARNINGS CUSTOM REPORTINGASTHMA PATIENTS ON BETA BLOCKERSPREGNANT PATIENTS ON CLASS D OR X MEDICATIONSBEERS CLASSIFIED MEDICATIONS IN THE ELDERLY
  66. 66. PATIENT SAFETY IDENTIFYING AND PREVENTING INAPPROPRIATE MEDICATION PRESCRIBING CUSTOM REPORTINGNARCOTIC ANALGESICSMETFORMIN IN PATIENTS WITH RENAL DISEASE
  67. 67. PATIENT SAFETYIDENTIFYING AND PREVENTING INAPPROPRIATE CODING CUSTOM REPORTINGPROBLEM LIST AUDIT REPORTS IDENTIFIED MISCODING OF PATIENTS (HIV, DIABETES).THIS LED TO ENHANCEMENTS IN DECISION SUPPORT WHICH PREVENTED FURTHER REOCCURENCES.
  68. 68. PERFORMANCE IMPROVEMENT IN QUALITY MEASURES MACROSOLUTIONS (i.e. DECISION SUPPORT, GLOBAL WORKFLOW CHANGES) ACCESS TO DATA ALLOWS FOR GREATER ABILITYTO PINPOINT PROBLEMS MICROSOLUTIONS (i.e. INDIVIDUAL PROVIDER ATTENTION)
  69. 69. PERFORMANCE IMPROVEMENT IN QUALITY MEASURESCQI INTERVENTIONS ARE APPLIED WITH CONTINUED REASSESSMENT DECISION SUPPORT ALERTS ACCOMPANIED BY WORKFLOW CHANGES. IFH – AGGRESSIVE IMPLEMENTATION OF BEST PRACTICE ALERTS 9 MONTHS AFTER GO-LIVE
  70. 70. IFH BEST PRACTICE ALERTSPRIMARILY BASED ON HEDIS CRITERIA • PneumoVax • Seasonal FluVax • Breast Cancer Screening • Cervical Cancer Screening • Lead Screening • HGBA1C Testing & Control
  71. 71. IFH BEST PRACTICE ALERTS• Ophthalmology consults for diabetics.• Peak Flow measurements for all asthmatics• Nephrology consults for patients with greater than 1.8 serum creatinine.• LDL Screening• Annual RPR Screening in HIV
  72. 72. Number of Vaccinations Given Ja n 10 20 30 40 50 60 0 M -02 ar M -02 ay - Ju 02 Se l-02 p N -02 ov Ja -0 2 n M -03 ar M -03 ay - Ju 03 Se l-03 p N -03 ov Ja -0 3 n M -04 ar M -04 ay - Ju 04 Se l-04 p N -04 ov Ja -0 4 nElectronic Reminders Begin M -05 ar M -05 ay - Ju 05 Se 5l-0 p N -05 ov Ja -0 5 n M -06 ar M -06 ay - Ju 06 Se l-06 p N -06 ov Ja -0 6 n M -07 ar M -07 ay - Monthly Pneumonia Vaccinations Among 65+ Ju 07 PNEUMOVAX Se l-07 p N -07 ov Increase Preventive Services Ja -0 7 n M -08 ar M -08 ay Electronic Health Record Reminders - Ju 08 Se l-08 p N -08 ov Ja -0 8 n M -09 ar -0 9 5% -5% 15% 25% 35% 45% 55% 65% 75% 85% 95% Percent Vaccinated (Since Jan 2002)
  73. 73. COLORECTAL CANCER SCREENING Colorectal Screening IFH Sites 2005 to 2008100% BPA FOR COLORECTAL SCREENING INITIATED90% JAN 200880%70% EAST 13TH ST. FAMILY HLTH CTR60% MT. HOPE FAMILY HEALTH CENTER PARKCHESTER FAMILY HLTH CTR50% PHILLIPS FAMILY PRACTICE SIDNEY HILLMAN FAMILY HLTH CTR40% URBAN HORIZONS FAMILY HLTH CTR WALTON FAMILY HEALTH CTR30%20% All sites listed10% were fully on 0% the EHR as of Jan 2003 05 05 05 06 06 06 06 06 06 07 07 07 07 07 07 08 08 08 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 1/ 1/ 1/ 8/ 0/ 0/ 1/ 1/ 1/ 8/ 0/ 0/ 1/ 1/ 1/ 9/ 0/ 0/ /3 /3 /3 /2 /3 /3 /3 /3 /3 /2 /3 /3 /3 /3 /3 /2 /3 /3081012020406081012020406081012020406
  74. 74. 05 /3 1/2 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 00 100%07 5 /3 1/ 2009 05 /3 0/ 2011 05 /3 0/ 2001 05 /3 1/ 2003 06 /3 1/ 2005 06 /3 1/ 2007 06 /3 1/ NURSING SHORTAGE 20 PERSONNEL09 06 /3 0/ 2011 06 /3 0/ 2001 06 /3 1/ 2003 07 /3 1/ 2005 07 /3 1/ 2007 07 /3 1/ 2009 07 /3 NURSING RESOLVED SHORTAGE 0/ 2011 07 /3 0/ 2001 07 /3 PARKCHESTER DEPRESSION SCREENING RATE 1/ 2003 08 /3 1/ 20 08 TO BPA ADHERENCE STEPPED UP VIGILANCE PARKCHESTER
  75. 75. THE INSTITUTE FOR URBANFAMILY HEALTH ROUTINE HIV SCREENING AT IFH NYC SITES 100% NYSDOH POLICY DECISION 90% CHANGE SUPPORT 80% FEBRUARY 2010 INITIATED 70% 60% 50% 40% 30% 20% 10% 0% 09/30/2007 12/31/2007 03/31/2008 06/30/2008 09/30/2008 12/31/2008 03/31/2009 06/30/2009 09/30/2009 12/31/2009 03/31/2010 06/30/2010 09/30/2010 12/31/2010
  76. 76. THE INSTITUTE FOR URBANFAMILY HEALTH TCNY REPORT: KNOW YOUR HIV STATUS100% DECISION SUPPORT INITIATED NYSDOH POLICY 90% CHANGE 2/2010 80% 70% AMSTERDAM AVENUE EAST 13TH ST. FAMILY HLTH CTR 60% HOMELESS CENTERS MT. HOPE FAMILY HEALTH CENTER 50% PARKCHESTER FAMILY HLTH CTR 40% PHILLIPS FAMILY PRACTICE SIDNEY HILLMAN FAMILY HLTH CTR 30% URBAN HORIZONS FAMILY HLTH CTR 20% WALTON FAMILY HEALTH CENTER 10% 0%
  77. 77. THE INSTITUTE NYCDOH EQUITS SMOKING FOR URBANFAMILY HEALTH CESSATION REPORT 100% 90% 80% 70% 60% 58% 52% 50% 48% ALL NYC SITES IFH CLINICAL SITES 40% 33% 28% 30% 30% 20% 10% 0% BASELINE QUARTER 1, 2011 QUARTER 2, 2011
  78. 78.  The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it. Michelangelo
  79. 79. Office of Health Information Technology and Quality Additional HRSA Health IT and Quality Toolboxes and Resources including past webinars can be found at: http://www.hrsa.gov/healthit http://www.hrsa.gov/qualityAdditional questions can sent to the following e-mail address: HealthIT@hrsa.gov • US Department of Health and Human Services • Health Resources and Services Administration

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