Better Health Care Through Electronic Records Program

Helps Doctors Treat Chronic Conditions

Mayor Michael R. Bloomberg, Deputy for Health and Human Services Linda I. Gibbs, Health Commissioner Thomas A. Farley announced that the use of electronic health records has led to better health outcomes for tens of thousands New Yorkers in the critical areas of high blood pressure management, diabetes and tobacco control.

New York City’s introduction of electronic health records, which has become a national model, was a result of the Primary Care Information Project, a program that began in 2005 to help medical providers, particularly those with underserved patients, use technology to improve the quality and efficiency of health care. The prompts that electronic health records give doctors, such as signaling a daily dose of aspirin to prevent heart disby ease or follow up questions for someone who smokes, make a dramatic difference in how aggressively they treat the chronic health conditions of their patients.

Through 3,200 primary care providers serving more than three million New Yorkers with electronic health records, over 96,000 additional patients reduced their high blood pressure, 81,000 patients improved their diabetes management and an additional 58,000 smokers were given assistance and successfully quit.

“Our Administration has focused on improving health care in New York by empowering health care providers-at every level-as well as their patients,” said Bloomberg. “We’ve focused on expanding the use of preventive care to tackle some of the biggest health challenges we face: heart and respiratory diseases; diabetes; and high blood pressure. The development and expanded use of electronic health records has given doctors the tools to improve both the length and quality of New Yorkers’ lives and it is rewarding to see the program become a national model.”

“A small number of services that can be delivered in doctors’ offices are proven to prevent common diseases like heart disease and cancer, but these services are not used enough,” added Farley. “The Primary Care Information Project has now shown that, through the help of information technology, primary care providers can substantially improve their delivery of these services, thereby improving the health of many thousands of patients.”

“By helping doctors care for patients better, PCIP has helped tens of thousands of New Yorkers avoid heart attacks, strokes, and death at a young age,” said Dr. Tom Frieden, director of the Centers for Disease Control. “PCIP shows that when the guiding principle is getting the most health benefit, health records can improve patient health dramatically.”

The Primary Care Information Project was started in New York City by Dr. Farzad Mostashari under then- Health Commissioner Frieden as a $27 million city initiative to use technology to improve the quality and efficiency of health care throughout the five boroughs, especially in some of New York City’s medically underserved neighborhoods: East and Central Harlem, the South Bronx, and Central Brooklyn.

More than 3,200 medical providers treating three million New Yorkers received electronic health record software and training to learn how to use it in their practices.

Patients served by doctors participating in the program were, for example, reminded to take daily aspirin doses to prevent heart disease or counseled to quit smoking. Electronic health records also permit doctors to view data on their entire population of patients, which helps them modify their routine office practices to help all of their patients and then evaluate how well those changes work.

Between 2008 and 2011, the number of preventive care services participating doctors provided grew, on average, by about 290 percent, from 39 services per 100 patients to 113 services per 100 patients-nearly a threefold increase.

The use of this technology led to improvements in detecting certain preventable health problems, including high blood pressure, tobacco use, high cholesterol, and diabetes. With the help of electronic health records, an additional 81,000 patients improved their management of diabetes, 96,000 New Yorkers got help controlling their high blood pressure. And an additional 58,000 smokers got help kicking the habit.

Early intervention in these illnesses is key to improving the health of New Yorkers and increasing life expectancy. Smoking is the leading cause of preventable premature death, and can lead to debilitating diseases such as cancer and heart disease; while steady decreasing, nearly 15 percent of New Yorkers reported being smokers in 2011.

Obesity is also a leading cause of preventable death, and causes a number of illnesses including diabetes which, if left untreated, diabetes can lead to amputations, blindness and many other consequences. In 2011,11 percent of New Yorkers reported that they had diabetes.

High blood pressure, a consequence of both smoking and obesity, damages the heart, brain, arteries and kidneys. Nearly 29 percent of New Yorkers reported being diagnosed with high blood pressure in 2011.

The success of the city’s Primary Care Information Project inspired a national initiative to introduce electronic health records to medical providers across the country as a way of improving the quality of care. The Office of the National Coordinator for Health Information Technology has funded 62 Regional Extension Centers to help over 132,000 primary care providers adopt electronic health records.

To date, more than 8,000 health care providers incorporate electronic health records into their practices NYC REACH members have received over $30 million in federal and state incentive funds as a result of their adoption of electronic health records, which they are reinvesting in their practices. Many of these providers are in private practices operating in underserved neighborhoods in the Bronx, Brooklyn and Upper Manhattan. NYC REACH is also supporting adoption and information exchange across Queens and Staten Island.

With new federal funding for 2013, NYC REACH is now working to help behavioral health professionals and specialists with high numbers of Medicaid patients adopt and implement electronic health records to continue to improve care across the city.

For more information about the Primary Care Information Project, visit nyc.gov.

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