Quality and Cost Improvement of Healthcare via Complementary Measurement and Diagnosis of Patient General Health Outcome
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ORIGINAL PAPER
Quality and Cost Improvement of Healthcare via Complementary Measurement and Diagnosis of Patient General Health Outcome Using Electronic Health Record Data: Research Rationale and Design Rodolfo J. Stusser & Richard A. Dickey
Received: 11 May 2013 / Accepted: 29 August 2013 / Published online: 18 September 2013 # Springer Science+Business Media New York 2013
Abstract In this evolving ‘third era of health’, one of the US Health Care Reform Act’s goals is to effectively facilitate the primary care physician’s ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient’s health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician’s clinical judgment, calculating a mathematical ‘health equation’ from each patient’s EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors’ assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner’s best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and Rodolfo Stusser is already retired in Cuba and currently working in the USA. R. J. Stusser (*) Clinical Biostatistics, Havana University, Institutes of Health, Miami, FL, USA e-mail: [email protected] R. A. Dickey Clinical Endocrinology, Wake Forest University, Winston-Salem, NC, USA
research. It could advance the approaches and focus of the ‘eras of diseases’, to the promising ‘era of health’, in an integrated, general approach to ‘health.’ Keyword Health status . Diagnostic algorithm . Health care outcome assessment . Clinical decision support system . Electronic health record . Primary health care . Outpatients . Research design . Quality of health care . Health care costs . Health promotion . Medical informatics . Health care reform
Introduction “When you can measure what you are speaking about, and express it in numbers, you know something about it.” Lord Kelvin, 1883 [1].
The US health status and care trends and present needs The US healthcare industry uses research to enhance the health, lives, and control the costs for the care o
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